go back

South Dakota rates for HCPCS J0222

Injection, patisiran, 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.97 / $99.97 / $99.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.97 / $99.97 / $120.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.85 / $101.85 / $101.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.91 / $100.91 / $126.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.42 / $142.74 / $273.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.04 / $99.82 / $109.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.60 / $119.78 / $172.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.67 / $119.78 / $254.94
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.40 / $109.40 / $109.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.83 / $99.97 / $109.97
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.82 / $99.82 / $99.82
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.82 / $99.82 / $99.82