go back

South Dakota rates for HCPCS J1562

Injection, immune globulin (Vivaglobin), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.15 / $10.15 / $10.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.92 / $10.15 / $11.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.50 / $7.58 / $9.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.87 / $13.38 / $21.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.06 / $16.13 / $16.13
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.87 / $11.65 / $17.20
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.48 / $15.24 / $23.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $14.40 / $16.13