go back

South Dakota rates for HCPCS J9229

Inj inotuzumab ozogam 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,698.05 / $2,698.05 / $2,698.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,698.05 / $2,698.05 / $3,264.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,698.05 / $2,708.29 / $3,385.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,698.05 / $4,559.70 / $5,396.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,698.05 / $3,003.50 / $11,735.90
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,189.75 / $3,468.22 / $4,515.26
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,189.75 / $3,987.19 / $4,047.08
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,952.58 / $2,952.58 / $2,952.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,698.05 / $2,698.05 / $3,210.68
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,952.59 / $2,952.59 / $2,952.59
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,952.59 / $2,952.59 / $2,952.59