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Connecticut rates for HCPCS 90396

Varicella-zoster immune globulin, human, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $6,606.93 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,344.23 / $2,344.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $3,548.13 / $5,370.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,344.23 / $2,344.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,570.40
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $56.23 / $56.23
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $63.10 / $63.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,511.89 / $2,754.23