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Washington, DC rates for HCPCS J0257

Injection, alpha 1 proteinase inhibitor (human), (GLASSIA), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.64 / $16.10 / $21.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.64
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $8.38 / $14.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.32 / $5.32 / $5.64
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $5.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.13 / $5.64 / $9.14