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South Dakota rates for HCPCS J7686

Treprostinil, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose form, 1.74 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$796.09 / $796.09 / $796.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.09 / $796.09 / $968.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$774.75 / $796.09 / $968.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.15 / $1,352.25 / $3,356.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.13 / $800.15 / $1,027.95
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$637.54 / $912.18 / $960.18
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.81 / $846.28 / $1,140.23
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$871.19 / $871.19 / $871.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.09 / $796.09 / $1,003.40
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.15 / $800.15 / $800.15
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$800.15 / $800.15 / $875.64