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South Dakota rates for HCPCS J9118

Injection, calaspargase pegol-mknl, 10 units

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.08 / $82.08 / $82.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.08 / $82.08 / $99.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.95 / $82.07 / $97.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.91 / $138.43 / $163.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.91 / $91.18 / $337.90
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.83 / $99.48 / $117.85
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.83 / $98.73 / $122.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.82 / $89.82 / $89.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.08 / $82.08 / $91.37
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.63 / $89.63 / $89.63
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.63 / $89.63 / $89.63