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South Dakota rates for HCPCS J7121

5% Dextrose In Lactated Ringers Infusion, Up To 1000 Cc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $57.54 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.31 / $7.08 / $12.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $10.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.58 / $12.30 / $154.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $7.94 / $7.94
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $8.13 / $8.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $7.94
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.94 / $7.94 / $7.94