go back

South Dakota rates for HCPCS J7643

Glycopyrrolate Comp Unit

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.74 / $0.74 / $0.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.89 / $0.89 / $95.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $0.89 / $0.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.19 / $5.19 / $5.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $0.89 / $1.02