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South Dakota rates for HCPCS J7194

Factor Ix Complex Per I.U. (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.70 / $1.70 / $1.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $1.70 / $2.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.70 / $2.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.31 / $2.43 / $4.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $1.70 / $1.87
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.65 / $1.99 / $2.91
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.90 / $2.48
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $1.86 / $1.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $1.70 / $1.87
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.70 / $1.70 / $1.70
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $1.70 / $1.70