go back

South Dakota rates for HCPCS J7208

Injection, Factor VIII, (antihemophilic factor, recombinant), PEGylated-aucl, (Jivi), 1 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.65 / $2.65 / $2.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.65 / $2.65 / $3.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.48 / $2.65 / $3.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.94 / $3.79 / $7.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.45 / $2.65 / $2.92
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.44 / $3.07 / $4.29
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.62 / $2.94 / $5.30
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.90 / $2.90 / $2.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.65 / $2.65 / $2.92
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.65 / $2.65 / $2.65
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.65 / $2.65 / $2.65