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Louisiana rates for HCPCS J0221

Injection, alglucosidase alfa, (Lumizyme), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$206.59 / $212.81 / $456.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.59 / $208.65 / $250.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.03 / $169.58 / $203.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.84 / $203.84 / $207.92
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.90 / $194.90 / $206.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.59 / $206.59 / $206.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.65 / $206.59 / $278.02