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South Dakota rates for HCPCS J0882

Injection, darbepoetin alfa, 1 mcg (for ESRD on dialysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,773.15 / $12,773.15 / $12,773.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.93 / $2.93 / $590.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.93 / $2.96 / $3.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.00 / $5.07 / $7.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.92 / $3.00 / $1,664.49
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.50 / $4.46 / $6.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $3.75 / $4.76
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.20 / $3.20 / $7.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.49 / $2.93 / $3.22
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.00