go back

South Dakota rates for HCPCS J7682

Tobramycin, inhalation solution, FDA-approved final product, noncompounded, unit dose form, administered through DME, per 300 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $16.22 / $16.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $16.22 / $17.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.08 / $16.22 / $18.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.20 / $39.61 / $141.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.58 / $14.46 / $32.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.35 / $19.20 / $54.42
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.35 / $39.43 / $111.37
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.75 / $17.75 / $17.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.00 / $16.22 / $18.17
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.46 / $14.46 / $14.46
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.46 / $14.46 / $15.82