go back

South Dakota rates for HCPCS J7626

Budesonide, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose form, up to 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.35 / $1.35 / $1.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.35 / $1.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.24 / $1.35 / $1.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.69 / $3.51 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.28 / $2.70
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.43 / $1.53 / $4.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $2.12 / $5.78
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $1.47 / $1.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $1.35 / $1.51
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.28 / $1.28 / $1.28
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.28 / $1.40