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South Dakota rates for HCPCS J2502

Injection, pasireotide long acting, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $575.44 / $977.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $588.84 / $724.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $812.83 / $1,548.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $562.34 / $575.44
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $676.08 / $676.08
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $630.96 / $630.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $575.44 / $660.69
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44