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South Dakota rates for HCPCS J9177

Injection Enfortumab Vedotin-Ejfv 0.25 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.74 / $36.74 / $36.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $36.74 / $44.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $37.35 / $46.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.65 / $61.96 / $73.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.65 / $40.81 / $161.83
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.97 / $47.64 / $61.30
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.97 / $51.73 / $54.99
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.21 / $40.21 / $40.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $37.00 / $43.72
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.11 / $40.11 / $40.11
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.11 / $40.11 / $40.11