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South Dakota rates for HCPCS J1554

Injection, immune globulin (Asceniv), 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.74 / $496.74 / $496.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.74 / $496.74 / $600.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$506.10 / $506.10 / $506.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.06 / $506.06 / $632.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$567.88 / $710.01 / $1,360.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.51 / $556.09 / $556.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$593.96 / $596.02 / $866.20
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$564.27 / $595.80 / $742.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$543.60 / $543.60 / $543.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.97 / $496.74 / $556.35
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.51 / $496.51 / $496.51
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.51 / $496.51 / $496.51