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South Dakota rates for HCPCS Q4081

Injection, epoetin alfa, 100 units (for ESRD on dialysis)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $1.70 / $2.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $0.79 / $0.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.78 / $1.29 / $2.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $0.85 / $1,348.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $0.85 / $0.91
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.15 / $1.15 / $1.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $0.85 / $0.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $0.83 / $0.91
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $0.85 / $0.85
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $0.85 / $0.85