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South Dakota rates for HCPCS J7665

Mannitol For Inhaler

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.89 / $7.89 / $7.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.62 / $6.71 / $8.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.89 / $0.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.89 / $10.15 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $6.58 / $7.24
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $0.89 / $0.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.69 / $0.87 / $1.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.59 / $6.58 / $7.37
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $0.98 / $0.98
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $0.98 / $0.98