go back

South Dakota rates for HCPCS J9209

Injection, mesna, 200 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.86 / $1.86 / $1.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.61 / $1.86 / $5.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $1.73 / $1.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.33 / $2.25 / $13.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.48 / $179.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.63 / $2.04 / $3.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.63 / $2.37 / $4.26
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.02 / $60.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.58 / $1.86 / $2.21
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.46 / $1.46 / $1.46
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.46 / $1.46 / $1.46