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South Dakota rates for HCPCS 90284

Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $15.14 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $25.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.80 / $13.80 / $17.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.47 / $21.38 / $40.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $16.98 / $16.98
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $15.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $17.38 / $19.50
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.79 / $14.79 / $14.79