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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
$1.69 / $1.69 / $1.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.58 / $1.69 / $1.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.65 / $1.69 / $2.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.57 / $2.25 / $4.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.57 / $1.57 / $1.73
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.53 / $1.88 / $2.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.53 / $1.90 / $2.48
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $1.84 / $1.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.69 / $1.86
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.57 / $1.57 / $1.57
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.57 / $1.57 / $1.57