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South Dakota rates for HCPCS J2788

Rho D Immune Globulin 50 Mcg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.59 / $25.59 / $25.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.59 / $31.48 / $33.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.08 / $25.59 / $30.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.47 / $41.05 / $76.34
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.62 / $27.86 / $30.65
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.88 / $29.47 / $34.34
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.88 / $28.34 / $36.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.00 / $28.00 / $53.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.59 / $25.59 / $28.15
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.86 / $27.86 / $27.86
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.86 / $27.86 / $27.86