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South Dakota rates for HCPCS Q5124

Injection, ranibizumab-nuna, biosimilar, (Byooviz), 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.80 / $61.80 / $61.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.80 / $62.40 / $77.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.19 / $87.19 / $108.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.87 / $105.03 / $279.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.80 / $62.15 / $72.73
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.58 / $253.80 / $319.91
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.58 / $194.81 / $319.91
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.12 / $64.12 / $64.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.80 / $61.80 / $67.98
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.15 / $62.15 / $62.15
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.15 / $62.15 / $62.15