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South Dakota rates for HCPCS M0201

Administration Of Pneumococcal Influenza Hepatis B And/Or Covid-19 Vaccine Inside A Patients Home; Reported Only Once Per Individual Home Per Date Of Service When Such Vaccine Administration(S) Are Performed At The Patients Home (Desc Rvsd 1/1/2024)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.50 / $35.50 / $39.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.10 / $39.10 / $39.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.19 / $39.19 / $48.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.01 / $49.01 / $49.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.99 / $42.97 / $75.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.71 / $55.99 / $63.24
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.64 / $56.72 / $77.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.98 / $38.54 / $71.62
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.90 / $36.90 / $36.90