go back

South Dakota rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Facilitymedian $269 · 10th–90th $251–$5010%50%10th90th$269Professionalmedian $251 · 10th–90th $251–$3720%50%90th$251$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $407.38
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $251.19 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $251.19 / $302.00
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $501.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $275.42 / $1,071.52
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $316.23 / $371.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $269.15 / $302.00
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $275.42
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $275.42 / $275.42