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South Dakota rates for HCPCS J7631

Cromolyn sodium, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose form, per 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.44 / $0.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.35 / $0.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.79 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $3.92
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $0.35 / $1.79
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.67 / $6.90
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.66
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.31