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South Dakota rates for HCPCS J1447

Injection, tbo-filgrastim, 1 mcg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.51 / $1.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.33 / $0.41
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.59 / $0.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.49 / $0.77
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.53
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.30
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.30