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South Dakota rates for HCPCS J3030

Injection, sumatriptan succinate, 6 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.40 / $44.40 / $44.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.85 / $41.27 / $44.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.00 / $54.00 / $67.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.86 / $62.10 / $118.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $37.00 / $51.75
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.10 / $66.61 / $98.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.63 / $87.09 / $140.76
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.16 / $72.25 / $72.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $37.00 / $40.70
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.00 / $49.00 / $49.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.00 / $49.00 / $49.00