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South Dakota rates for HCPCS J8655

Netupitant 300 mg and palonosetron 0.5 mg, oral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $380.19 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $380.19 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $389.05 / $489.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $588.84 / $831.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $457.09 / $1,949.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $524.81
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $281.84 / $281.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $416.87 / $416.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $426.58 / $457.09
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $467.74 / $467.74
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $467.74 / $467.74