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Pennsylvania rates for HCPCS J0256

Injection, alpha 1-proteinase inhibitor (human), not otherwise specified, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.24 / $7.86 / $15.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.46 / $5.51 / $11.42
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.03 / $5.92 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.66 / $5.66 / $5.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.15 / $5.46 / $5.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.46 / $5.46 / $5.46
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.24 / $7.99 / $15.78
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.24 / $5.51 / $15.78
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.15 / $5.46 / $5.46
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.46 / $5.46 / $5.46
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.59 / $4.59 / $5.33
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.59 / $4.59 / $5.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.46 / $5.46 / $7.54