go back

South Dakota rates for HCPCS J2562

Plerixafor Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.33 / $25.33 / $25.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $25.33 / $144.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.43 / $25.43 / $31.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.65 / $201.90 / $518.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $119.47 / $133.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.97 / $64.89 / $571.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.27 / $320.52 / $571.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.72 / $27.72 / $33.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $25.33 / $28.20
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.47 / $119.47 / $119.47
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.47 / $119.47 / $119.47