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South Dakota rates for HCPCS J7634

Budesonide, inhalation solution, compounded product, administered through DME, concentrated form, per 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.00 / $23.00 / $23.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.13 / $1.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.15 / $2.15 / $2.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.64 / $0.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $5.01 / $5.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.57 / $0.68 / $0.76