go back

South Dakota rates for HCPCS P9043

Infusion Plasma Protein Fraction (Human) 5% 50 Ml (Special Coverage Instructions Apply. See Mcm: 2455b)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.02 / $27.02 / $27.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.43 / $27.02 / $27.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.75 / $12.19 / $12.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.54 / $36.39 / $66.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.59 / $22.52 / $24.77
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.48 / $19.17 / $25.79
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.39 / $22.86 / $37.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.52 / $22.52 / $24.77
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $8.07
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.07 / $8.07 / $8.07