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South Dakota rates for HCPCS J1454

Injection, fosnetupitant 235 mg and palonosetron 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $549.54 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $549.54 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $562.34 / $691.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $645.65 / $1,202.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $676.08 / $2,884.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $758.58 / $851.14
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $446.68
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $602.56 / $602.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $602.56 / $645.65
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44