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South Dakota rates for HCPCS J2777

Injection Faricimab-Svoa 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $33.88 / $33.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $34.21 / $42.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.36 / $35.72 / $44.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.47 / $58.27 / $94.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.47 / $34.47 / $155.61
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.37 / $45.82 / $75.01
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.37 / $41.67 / $75.01
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.07 / $37.07 / $37.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $40.54
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.47 / $34.47 / $34.47
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.47 / $34.47 / $34.47