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South Dakota rates for HCPCS J1300

Injection, eculizumab, 10 mg

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.38 / $228.38 / $285.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$268.99 / $268.99 / $268.99
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$268.99 / $277.32 / $392.28
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.36 / $271.95 / $336.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.45 / $245.31 / $245.31