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South Dakota rates for HCPCS J0584

Injection Burosumab-Twza 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$484.14 / $484.14 / $484.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$484.14 / $484.14 / $582.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$493.28 / $493.28 / $493.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.61 / $484.14 / $598.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$550.20 / $688.65 / $1,319.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.74 / $481.57 / $529.73
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$563.66 / $569.91 / $822.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.63 / $563.69 / $944.69
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.80 / $529.80 / $529.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.73 / $484.14 / $532.54
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$481.57 / $481.57 / $481.57
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.57 / $481.57 / $481.57