go back

South Dakota rates for HCPCS J3411

Injection, thiamine HCl, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $89.68 / $128.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $1.88 / $9.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $1.82 / $2.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.12 / $3.03 / $5.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $1.79 / $1.97
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.11 / $2.14 / $3.66
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $3.31 / $4.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.98 / $1.98 / $1.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $1.82 / $2.00
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.79 / $1.79 / $1.79
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.79 / $1.79 / $1.79