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South Dakota rates for HCPCS J9022

Injection, atezolizumab, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.34 / $91.34 / $91.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.34 / $92.25 / $110.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.44 / $109.44 / $109.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.09 / $91.34 / $113.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.02 / $153.82 / $182.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.02 / $101.32 / $389.52
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.87 / $116.77 / $148.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.27 / $132.33 / $136.53
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.96 / $99.96 / $99.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.34 / $91.34 / $102.01
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.61 / $99.61 / $99.61
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.61 / $99.61 / $99.61