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South Dakota rates for HCPCS J9208

Injection, ifosfamide, 1 g

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $23.99 / $50.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $25.12 / $31.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $37.15 / $64.57
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $26.30 / $562.34
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $32.36 / $35.48
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $31.62 / $31.62
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $26.92 / $234.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $27.54 / $30.20
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54