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South Dakota rates for HCPCS J9246

Injection Melphalan (Evomela) 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.50 / $18.50 / $18.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.55 / $18.50 / $21.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.86 / $18.86 / $23.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.60 / $29.36 / $47.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.37 / $19.34 / $20.59
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.60 / $26.06 / $31.50
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.73 / $26.06 / $28.64
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.23 / $20.23 / $20.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.50 / $18.50 / $20.59
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.01 / $19.01 / $19.01
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.01 / $19.01 / $19.01