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South Dakota rates for HCPCS J7189

Factor Viia (Antihemophilic Factor Recombinant) (Novoseven Rt) 1 Microgram (Desc Rvsd 1/1/21)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.66 / $2.66 / $2.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $2.66 / $3.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.59 / $2.65 / $3.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.21 / $3.79 / $7.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.52 / $2.65 / $2.92
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.37 / $3.06 / $4.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.06 / $2.91 / $3.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.39 / $2.90 / $2.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $2.66 / $2.66
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.65 / $2.65 / $2.65
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.65 / $2.65 / $2.65