go back

South Dakota rates for HCPCS J2502

Injection, pasireotide long acting, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$572.96 / $572.96 / $572.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$569.42 / $572.96 / $682.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.89 / $542.26 / $671.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$434.99 / $806.22 / $1,544.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.94 / $563.79 / $620.16
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$632.33 / $676.55 / $933.63
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$632.33 / $676.55 / $1,436.32
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$627.01 / $627.01 / $627.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$572.96 / $572.96 / $630.26
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$563.79 / $563.79 / $563.79
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563.79 / $563.79 / $563.79