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South Dakota rates for HCPCS Q2028

Injection Sculptra 0.5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.78 / $0.78 / $0.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.65 / $0.71 / $0.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.89 / $1.04 / $1.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.67 / $0.67 / $0.74
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.50 / $1.50 / $1.75
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.22 / $1.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.67 / $0.67 / $0.74
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00