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South Dakota rates for HCPCS J9304

Injection, pemetrexed (Pemfexy), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $38.90 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $38.90 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $40.74 / $51.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $63.10 / $107.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $58.88 / $234.42
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $69.18 / $79.43
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $43.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $44.67 / $52.48
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12