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South Dakota rates for HCPCS 90284

Immune Globulin Human Subq Infusion 100 Mg Ea

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.17 / $15.17 / $15.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.89 / $15.17 / $15.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.88 / $14.01 / $17.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.53 / $21.29 / $40.79
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.02 / $16.85 / $16.85
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.44 / $16.44 / $16.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.17 / $15.17 / $15.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.43 / $16.85 / $17.30
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.60 / $14.60 / $14.60
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.60 / $14.60 / $14.60