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South Dakota rates for HCPCS J7310

Ganciclovir, 4.5 mg, long-acting implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,601.09 / $4,601.09 / $4,601.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,590.56 / $3,913.26 / $15,936.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,960.13 / $16,960.13 / $21,200.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,134.50 / $9,838.12 / $26,288.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,209.54 / $19,200.00 / $21,120.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,925.72 / $5,282.90 / $7,792.09
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,650.14 / $7,792.09 / $20,352.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,896.00 / $19,200.00 / $21,120.00