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South Dakota rates for HCPCS J3430

Injection, phytonadione (vitamin K), per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $5.62 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $4.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.82 / $2.82 / $3.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.63 / $4.79 / $7.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $2.82 / $2.82
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.39 / $3.39 / $3.39
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $3.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.19 / $2.82 / $3.09
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.75 / $2.75 / $2.75