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South Dakota rates for HCPCS 90396

Varicella-zoster immune globulin, human, for intramuscular use

Facilitymedian $2,291 · 10th–90th $2,291–$2,3440%50%90th$2,291Professionalmedian $2,344 · 10th–90th $2,188–$2,7540%50%10th90th$2,344$10.0$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,754.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,754.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $3,311.31 / $6,309.57
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $2,570.40 / $2,570.40
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,454.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,754.23 / $2,884.03
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87