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South Dakota rates for HCPCS J1569

Gammagard Liquid Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.31 / $45.31 / $19,981.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.77 / $57.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.16 / $46.16 / $46.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.98 / $45.98 / $57.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.75 / $75.17 / $130.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $53.54 / $53.54
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.23 / $57.36 / $81.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.62 / $54.15 / $69.69
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.59 / $49.59 / $89.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $46.46 / $50.75
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.80 / $47.80 / $47.80
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.80 / $47.80 / $47.80