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South Dakota rates for HCPCS J9302

Injection Ofatumumab 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.40 / $72.40 / $72.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.92 / $61.54 / $72.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.18 / $65.83 / $81.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.96 / $97.88 / $158.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.34 / $67.17 / $2,649.11
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.26 / $240.66 / $300.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.11 / $105.53 / $275.85
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.54 / $61.54 / $61.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.34 / $60.34 / $71.80
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.98 / $69.98 / $69.98
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.98 / $69.98 / $69.98