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South Dakota rates for HCPCS J7658

Isoproterenol Hcl Inhalation Solution Administered Through Dme Concentrated Form Per Milligram (Special Coverage Instructions Apply. See Mcm: 2100.5)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.06 / $2.06 / $2.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $1.76 / $2.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.76 / $0.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.37 / $3.14 / $5.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $4.17 / $4.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.66 / $6.66 / $464.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.67 / $4.17 / $4.59