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South Dakota rates for HCPCS J3305

Injection, trimetrexate glucuronate, per 25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.55 / $176.55 / $176.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.54 / $176.55 / $176.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.25 / $155.25 / $194.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$201.97 / $237.71 / $435.39
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.80 / $136.80 / $150.47
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.59 / $186.59 / $267.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.80 / $136.80 / $150.47