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South Dakota rates for HCPCS J9307

Injection, pralatrexate, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$392.63 / $392.63 / $392.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$392.63 / $392.63 / $470.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.81 / $392.63 / $476.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$383.86 / $657.12 / $777.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$388.83 / $432.85 / $6,283.71
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.40 / $485.90 / $583.24
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.92 / $448.52 / $583.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.73 / $429.66 / $429.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$392.63 / $392.63 / $437.08
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.51 / $425.51 / $425.51
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.51 / $425.51 / $425.51