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South Dakota rates for HCPCS J0490

Belimumab Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.07 / $56.07 / $56.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.07 / $56.63 / $67.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.11 / $57.11 / $57.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.03 / $56.07 / $70.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.81 / $80.09 / $153.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.97 / $56.01 / $61.61
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.38 / $67.20 / $96.09
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.21 / $62.60 / $82.36
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.69 / $61.35 / $61.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.07 / $56.07 / $61.68
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.01 / $56.01 / $56.01
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.01 / $56.01 / $56.01