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Factor IX Albumin Fusion Protein (Idelvion) Injection

South Dakota rates for HCPCS J7202

Injection, Factor IX, albumin fusion protein, (recombinant), Idelvion, 1 IU

Rates data updated July 2026.

How much does Idelvion (coagulation factor ix recombinant human) cost?

$5.50per IU

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $5.50 for each IU of this drug. The price depends on where it is billed: about $5.50 from a physician practice, and about $5.37 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

Work out the cost of a dose

This drug is priced per IU. Enter the amount given to see what insurers have agreed to pay for it.

IU
In a doctor's office or clinic
$5.50
At a hospital outpatient department
$5.37

The same drug, in the same amount, costs 2% less at a hospital than at a doctor's office.

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$5.50$5.37 to $5.75
FacilityA hospital or hospital-owned outpatient department$5.37$5.37 to $5.37

How much rates vary

Facilitymedian $5 · 10th to 90th $5 to $11Professionalmedian $5 · 10th to 90th $5 to $7
$5$10facility $5professional $5

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$5.37
Median
$10.72
Typical High
$10.72
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$5.37
Typical High
$6.46
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$6.76
Medica
Setting
Facility
Modifier
Global
Typical Low
$6.31
Median
$7.59
Typical High
$14.79
Medica
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$5.37
Typical High
$5.37
Midlands
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$6.46
Typical High
$6.46
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$5.75
Median
$5.75
Typical High
$5.75
United
Setting
Professional
Modifier
Global
Typical Low
$5.25
Median
$5.37
Typical High
$6.17
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$5.37
Median
$5.37
Typical High
$5.37
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$5.37
Typical High
$5.37

Where South Dakota sits

The same service costs 2.3 times more in Delaware than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 27th of 51

$5.50

DE $12.30DC $5.37

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.