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South Dakota rates for HCPCS J0257

Injection, alpha 1 proteinase inhibitor (human), (GLASSIA), 10 mg

Facilitymedian $6 · 10th–90th $5–$70%50%10th90th$6Professionalmedian $6 · 10th–90th $5–$70%20%40%10th90th$6$5.0$10.0$20.0

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
$5.01 / $5.01 / $11.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $6.03
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $5.62 / $5.75
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.75 / $5.75 / $5.75
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $5.75 / $7.24
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $8.13 / $15.49
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $5.75 / $5.75
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $6.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $6.17 / $6.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $5.75 / $6.61
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.62 / $5.62 / $5.75