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South Dakota rates for HCPCS J1551

Injection, immune globulin (Cutaquig), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.23 / $14.23 / $14.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.23 / $14.23 / $17.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.51 / $14.51 / $14.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.59 / $14.59 / $18.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.32 / $24.01 / $38.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.21 / $15.92 / $16.05
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.05 / $17.20 / $17.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.17 / $17.05 / $21.77
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.58 / $15.58 / $15.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.10 / $14.23 / $15.94
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.21 / $14.21 / $14.21
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.21 / $14.21 / $14.21