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South Dakota rates for HCPCS J9027

Injection, clofarabine, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.19 / $4.19 / $4.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.19 / $4.19 / $17.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.78 / $16.30 / $20.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.72 / $24.88 / $155.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.72 / $16.39 / $3,115.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.99 / $19.88 / $227.94
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.21 / $68.70 / $199.39
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.58 / $4.58 / $4.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.19 / $4.19 / $5.49
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.11 / $16.11 / $16.11
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.11 / $16.11 / $16.11