go back

South Dakota rates for HCPCS J2507

Injection, pegloticase, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,660.83 / $3,660.83 / $3,660.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.68 / $3,697.44 / $4,612.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,729.90 / $3,729.90 / $3,729.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,632.59 / $3,660.83 / $4,540.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,294.60 / $5,203.57 / $9,970.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,565.32 / $3,638.86 / $4,002.75
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.62 / $4,366.64 / $6,212.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$888.31 / $4,047.05 / $5,325.07
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,919.73 / $4,006.20 / $4,006.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,660.83 / $3,660.83 / $4,026.91
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,638.86 / $3,638.86 / $3,638.86
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,638.86 / $3,638.86 / $3,638.86