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South Dakota rates for HCPCS J1559

Injection, immune globulin (Hizentra), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.34 / $14.34 / $14.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.26 / $14.34 / $17.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.63 / $14.63 / $14.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.91 / $14.34 / $17.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.26 / $20.19 / $38.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.12 / $15.81 / $15.81
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.79 / $16.95 / $23.87
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.51 / $15.55 / $20.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.69 / $15.69 / $24.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.19 / $14.34 / $16.05
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.12 / $14.12 / $14.12
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.12 / $14.12 / $14.12