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South Dakota rates for HCPCS J9130

Dacarbazine 100 Mg Inj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.45 / $3.45 / $3.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.45 / $3.86 / $4.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $4.58 / $5.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.82 / $6.46 / $9.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.82 / $6.37 / $111.13
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.00 / $5.69 / $6.26
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $5.73 / $6.43
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.77 / $3.77 / $3.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.45 / $3.66 / $6.37
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.18 / $4.18 / $4.18
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.18 / $4.18 / $4.18