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Tennessee 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
$14.89 / $15.17 / $24.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.17 / $15.17 / $15.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.64 / $16.64 / $16.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.64 / $16.64 / $16.64
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $214.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.32 / $15.32 / $23.60