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South Dakota rates for HCPCS J9359

Injection, loncastuximab tesirine-lpyl, 0.075 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.90 / $216.90 / $216.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.90 / $216.90 / $262.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.00 / $216.90 / $270.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.74 / $366.29 / $593.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.74 / $241.28 / $936.51
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$254.39 / $275.75 / $371.21
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.66 / $263.45 / $325.11
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.37 / $237.37 / $237.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.90 / $216.90 / $241.46
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$237.19 / $237.19 / $237.19
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.19 / $237.19 / $237.19