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South Dakota rates for HCPCS J0223

Injection, givosiran, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.36 / $117.36 / $117.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.36 / $117.36 / $141.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.59 / $119.59 / $119.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.69 / $118.69 / $148.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.29 / $167.58 / $321.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.47 / $117.19 / $128.91
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.56 / $140.63 / $202.07
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.63 / $139.77 / $278.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.44 / $128.44 / $128.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.36 / $117.36 / $129.10
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.19 / $117.19 / $117.19
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.19 / $117.19 / $117.19