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Pennsylvania rates for HCPCS 90284

Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $15.14 / $25.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $19.95 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $16.98 / $16.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $16.98 / $16.98
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $15.14 / $25.70
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $18.20
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.32 / $15.14 / $19.50
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $13.49 / $18.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $19.50 / $28.18