go back

South Dakota rates for HCPCS J3400

Injection, triflupromazine HCl, up to 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.00 / $13.00 / $13.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.79 / $13.00 / $13.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.13 / $10.23 / $12.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.87 / $17.50 / $32.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $13.00 / $14.30
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.34 / $14.34 / $14.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $13.00 / $14.30