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South Dakota rates for HCPCS J7204

Injection, Factor VIII, antihemophilic factor (recombinant), (Esperoct), glycopegylated-exei, per IU

Facilitymedian $2 · 10th–90th $2$40%50%10th90th$2Professionalmedian $2 · 10th–90th $2$30%20%40%10th90th$2$2.0$5.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $4.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.29 / $2.29 / $2.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.63 / $3.24 / $6.17
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $2.24 / $2.24
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.69 / $2.69 / $2.69
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $2.45 / $2.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.19 / $2.24 / $2.57
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.24 / $2.24 / $2.24