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South Dakota rates for HCPCS J3399

Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomes

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,394,480.06 / $2,394,480.06 / $2,394,480.06
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,561,516.79 / $2,561,516.79 / $2,561,516.79
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,391,705.60 / $2,391,705.60 / $2,391,705.60
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,391,705.60 / $2,391,705.60 / $2,391,705.60