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South Dakota rates for HCPCS J9303

Vectibix IV SOLN 100 MG/5ML

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.03 / $173.03 / $173.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.23 / $173.03 / $218.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.04 / $173.03 / $210.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$172.55 / $291.61 / $345.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.55 / $192.08 / $2,975.90
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.00 / $215.43 / $263.66
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.30 / $197.91 / $258.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.55 / $189.36 / $189.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.03 / $173.03 / $205.91
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.83 / $188.83 / $188.83
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.83 / $188.83 / $188.83