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South Dakota rates for HCPCS J7181

Injection, Factor XIII A-subunit, (recombinant), per IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.16 / $18.16 / $18.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.16 / $18.16 / $22.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.66 / $18.16 / $22.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.60 / $26.15 / $50.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.34 / $18.29 / $20.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.26 / $21.95 / $30.05
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.20 / $20.80 / $40.32
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.72 / $19.87 / $19.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.16 / $18.16 / $19.98
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.29 / $18.29 / $18.29
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.29 / $18.29 / $18.29