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South Dakota rates for HCPCS J2791

Rhophylac Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.86 / $4.86 / $9.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.86 / $6.01 / $121.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.99 / $4.99 / $6.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.87 / $8.40 / $13.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.86 / $4.97 / $5.47
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.74 / $5.87 / $6.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.58 / $5.76 / $7.34
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.31 / $5.31 / $5.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.86 / $4.86 / $5.35
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.97 / $4.97 / $4.97
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.97 / $4.97 / $4.97