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South Dakota rates for HCPCS J7321

Hyaluronan Or Derivative Hyalgan Supartz Or Visco-3 For Intra-Articular Injection Per Dose (Desc Rvsd 4/1/21)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.52 / $244.24 / $244.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.52 / $72.23 / $114.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.34 / $75.34 / $94.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.63 / $124.03 / $201.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.52 / $73.39 / $80.73
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.63 / $88.75 / $108.01
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.08 / $98.98 / $109.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.27 / $78.27 / $140.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.52 / $71.52 / $78.67
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.39 / $73.39 / $73.39
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.39 / $73.39 / $73.39