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South Dakota rates for HCPCS J9218

Leuprolide acetate, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.49 / $60.49 / $60.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.39 / $51.42 / $60.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.08 / $11.34 / $18.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $78.08 / $109.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.40 / $56.11 / $411.45
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.00 / $13.37 / $24.06
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.70 / $13.37 / $29.94
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.09 / $54.09 / $54.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.40 / $50.40 / $59.98
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.65 / $58.65 / $58.65
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.65 / $58.65 / $58.65