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South Dakota rates for HCPCS J1305

Injection Evinacumab-Dgnb 5mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.76 / $193.76 / $193.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.65 / $193.76 / $229.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$197.40 / $197.40 / $197.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.83 / $191.72 / $237.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219.35 / $320.68 / $519.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.31 / $189.75 / $208.73
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.57 / $257.47 / $326.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.87 / $223.57 / $279.45
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.04 / $212.04 / $212.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.31 / $193.76 / $213.14
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.75 / $189.75 / $189.75
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.75 / $189.75 / $189.75