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South Dakota rates for HCPCS J3303

Injection Triamcinolone Hexacetonide Per 5mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.75 / $9.75 / $9.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.08 / $8.28 / $9.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.75 / $3.79 / $4.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.71 / $11.15 / $24.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $8.13 / $8.94
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.71 / $2.92 / $5.05
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.33 / $3.82 / $5.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.90 / $3.90 / $3.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $8.13 / $8.94