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South Dakota rates for HCPCS J3485

Injection, zidovudine, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.54 / $1.54 / $1.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.53 / $2.52 / $4.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.66
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $1.82 / $2.14
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.72 / $1.82 / $2.27
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $1.66 / $1.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.66
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51