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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
$25.20 / $25.20 / $25.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.20 / $25.20 / $41.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.09 / $25.34 / $31.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.50 / $39.72 / $64.39
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.50 / $26.16 / $565.38
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.54 / $36.90 / $40.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.54 / $35.25 / $47.65
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.58 / $27.58 / $234.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.20 / $25.20 / $29.99
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.71 / $25.71 / $25.71
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.71 / $25.71 / $25.71