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South Dakota rates for HCPCS J9155

Degarelix Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.45 / $4.45 / $4.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.66 / $4.49 / $5.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.43 / $4.45 / $5.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.36 / $7.37 / $8.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.36 / $4.84 / $1,033.47
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $5.72 / $7.33
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.59 / $5.47 / $6.57
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.87 / $4.87 / $6.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $5.30
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.76 / $4.76 / $4.76
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.76 / $4.76 / $4.76