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Alglucosidase Alfa (Lumizyme) Injection

North Carolina rates for HCPCS J0221

Injection, alglucosidase alfa, (Lumizyme), 10 mg

Rates data updated July 2026.

How much does Lumizyme (alglucosidase alfa) cost?

$209per 10 mg

Typical negotiated rate. In North Carolina, July 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 $234 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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
$234

The same drug, in the same amount, costs 12% 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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$209$186 to $251
FacilityA hospital or hospital-owned outpatient department$234$200 to $347

How much rates vary

Facilitymedian $234 · 10th to 90th $186 to $427Professionalmedian $209 · 10th to 90th $186 to $347
$200$500facility $234professional $209

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$208.93
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$208.93
Typical High
$346.74
BCBS
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$316.23
Typical High
$426.58
BCBS
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$213.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$309.03
Typical High
$489.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$239.88
Medcost
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$208.93
Typical High
$245.47
United
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$338.84
Typical High
$380.19
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$269.15
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13

Where North Carolina sits

The same service costs 2.3 times more in Delaware than in Maryland. 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.

North Carolina· 39th of 51

$209

DE $490MD $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.