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Alglucosidase Alfa (Lumizyme) Injection

Illinois rates for HCPCS J0221

Injection, alglucosidase alfa, (Lumizyme), 10 mg

Rates data updated October 2026.

How much does Lumizyme (alglucosidase alfa) cost?

$209per 10 mg

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $209 for each 10 mg of this drug. The price depends on where it is billed: about $209 from a physician practice, and about $427 from a hospital or other facility.

Work out the cost of a dose

This drug is priced per 10 mg. Enter the amount given to see what insurers have agreed to pay for it.

mg
In a doctor's office or clinic
$209
At a hospital outpatient department
$427

The same drug, in the same amount, costs 104% more at a hospital than at a doctor's office.

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$209$209 to $229
FacilityA hospital or hospital-owned outpatient department$427$295 to $676

How much rates vary

Facilitymedian $427 · 10th to 90th $209 to $977Professionalmedian $209 · 10th to 90th $209 to $363
$200$500$1K$2Kfacility $427professional $209

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$208.93
Typical High
$776.25
Aetna
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$309.03
Median
$707.95
Typical High
$1,548.82
Cigna
Setting
Facility
Modifier
None
Typical Low
$281.84
Median
$426.58
Typical High
$501.19
Cigna
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
Hally Health
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$239.88
Typical High
$446.68
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
United
Setting
Facility
Modifier
None
Typical Low
$208.93
Median
$208.93
Typical High
$478.63
United
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$208.93
Typical High
$218.78
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$42.66
Median
$42.66
Typical High
$42.66
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$20.89
Median
$20.89
Typical High
$20.89

Where Illinois sits

The same service costs 1.6 times more in Arizona than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 46th of 51

$209

AZ $339NJ $209

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.