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South Dakota rates for HCPCS J7200

Injection, Factor IX, (antihemophilic factor, recombinant), Rixubis, per IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $3.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.78 / $1.78 / $2.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.58 / $2.24 / $4.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.38 / $1.58 / $1.70
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $1.86 / $1.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $1.91 / $1.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $1.74 / $1.91
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.70 / $1.70 / $1.70