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South Dakota rates for HCPCS J3396

Injection Verteporfin 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.54 / $11.54 / $11.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.54 / $11.65 / $13.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.74 / $11.74 / $14.67
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.83 / $18.48 / $31.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.52 / $11.55 / $12.71
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.91 / $13.86 / $20.13
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.86 / $13.24 / $17.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.63 / $12.62 / $12.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.54 / $11.54 / $12.69
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.55 / $11.55 / $11.55
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.55 / $11.55 / $11.55