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South Dakota rates for HCPCS J9042

Brentuximab Vedotin Inj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$258.64 / $258.64 / $258.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.64 / $258.64 / $312.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.61 / $258.64 / $317.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.40 / $436.90 / $517.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.52 / $287.79 / $6,942.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.63 / $323.61 / $403.57
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.39 / $298.72 / $387.77
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.58 / $283.04 / $283.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.64 / $258.64 / $307.77
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.89 / $282.89 / $282.89
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.89 / $282.89 / $282.89