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South Dakota rates for HCPCS J7195

Injection, Factor IX (antihemophilic factor, recombinant) per IU, not otherwise specified

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.85 / $1.85 / $1.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.85 / $1.85 / $2.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.88 / $1.88 / $2.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.09 / $2.69 / $5.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.85 / $1.88 / $2.06
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.80 / $2.22 / $3.22
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.64 / $2.10 / $2.76
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.53 / $2.02 / $2.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $1.85 / $2.04
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.88 / $1.88 / $1.88
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.88 / $1.88 / $1.88