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South Dakota rates for HCPCS J7193

Factor IX (antihemophilic factor, purified, nonrecombinant) per IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.40 / $1.40 / $1.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.40 / $1.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $1.40 / $1.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.20 / $1.92 / $3.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.34 / $1.34 / $1.47
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.35 / $1.61 / $2.35
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.21 / $1.53 / $2.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.53 / $1.53 / $1.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.40 / $1.40 / $1.54
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.34 / $1.34 / $1.34
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.34 / $1.34 / $1.34