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South Dakota rates for HCPCS J2820

Injection, sargramostim (GM-CSF), 50 mcg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.37 / $50.37 / $50.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.37 / $50.86 / $67.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.01 / $61.01 / $76.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.69 / $80.20 / $153.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.37 / $62.44 / $66.66
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.39 / $72.02 / $105.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.04 / $67.86 / $90.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.61 / $55.11 / $64.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.37 / $50.37 / $56.07
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.09 / $56.09 / $56.09
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.09 / $56.09 / $56.09