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South Dakota rates for HCPCS J2995

Injection Streptokinase Per 250 000 Iu (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.75 / $93.75 / $93.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.81 / $93.75 / $93.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.50 / $82.50 / $103.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.39 / $126.23 / $231.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.16 / $90.69 / $99.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.39 / $91.58 / $135.08
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.34 / $125.14 / $200.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.09 / $90.69 / $99.76