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South Dakota rates for HCPCS J2790

Rho D Immune Globulin Inj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.58 / $82.58 / $213.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.58 / $83.40 / $104.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.59 / $82.57 / $98.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.55 / $139.29 / $225.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.16 / $82.42 / $90.66
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.59 / $98.91 / $112.81
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.90 / $95.97 / $125.04
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.36 / $90.36 / $111.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.58 / $82.58 / $83.36
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.42 / $82.42 / $82.42
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.42 / $82.42 / $82.42