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South Dakota rates for HCPCS Q4112

Cymetra, injectable, 1 cc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$915.68 / $915.68 / $915.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.00 / $915.68 / $915.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$651.12 / $1,102.00 / $1,377.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$826.50 / $872.08 / $1,033.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$376.54 / $845.00 / $1,547.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$872.08 / $872.08 / $959.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$240.06 / $479.00 / $1,240.79
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.83 / $1,010.97 / $1,240.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$872.08 / $872.08 / $1,151.15