go back

South Dakota rates for HCPCS J7316

Injection, ocriplasmin, 0.125 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.20 / $1,185.20 / $1,185.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$983.72 / $983.72 / $1,007.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,066.50 / $1,066.50 / $1,333.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.20 / $1,306.94 / $1,761.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.20 / $1,185.20 / $1,303.72
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,256.09 / $1,306.94 / $1,460.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,186.18 / $1,256.09 / $2,732.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.20 / $1,185.20 / $1,303.72