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South Dakota rates for HCPCS J9600

Injection, porfimer sodium, 75 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,183.83 / $28,183.83 / $28,183.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22,387.21 / $23,442.29 / $28,183.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,162.28 / $3,981.07 / $23,988.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $28,183.83 / $44,668.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23,442.29 / $25,703.96 / $102,329.30
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $2,884.03 / $3,019.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $4,073.80 / $4,073.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23,988.33 / $23,988.33 / $23,988.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23,442.29 / $25,703.96 / $27,542.29
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,915.35 / $26,915.35 / $26,915.35
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26,915.35 / $26,915.35 / $26,915.35