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South Dakota rates for HCPCS Q5107

Injection Bevacizumab-Awwb Biosimilar (Mvasi) 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.86 / $27.86 / $27.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.86 / $28.14 / $35.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.38 / $33.38 / $33.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.68 / $30.38 / $37.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.85 / $48.76 / $79.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.85 / $32.11 / $126.83
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.79 / $43.09 / $67.52
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.61 / $35.79 / $45.76
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.91 / $25.91 / $25.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.86 / $27.86 / $37.92
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.85 / $28.85 / $28.85
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.85 / $28.85 / $28.85