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South Dakota rates for HCPCS J9280

Injection, mitomycin, 5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.35 / $20.35 / $20.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.35 / $20.55 / $34.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.98 / $26.06 / $32.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.72 / $47.78 / $87.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.27 / $31.47 / $573.77
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.00 / $60.25 / $182.18
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.72 / $42.41 / $141.57
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.27 / $22.27 / $191.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.35 / $20.35 / $24.92
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.94 / $30.94 / $30.94
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.94 / $30.94 / $30.94