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South Dakota rates for HCPCS J3121

Injection, testosterone enanthate, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $18.20 / $19.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.10 / $0.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.06 / $0.06
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.07 / $0.07
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.06
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.05