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Hawaii rates for HCPCS J0257

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.36 / $10.36 / $10.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.37 / $10.37 / $10.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.64
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.03 / $8.03 / $8.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.20 / $6.77 / $7.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $6.61 / $8.46
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.09 / $6.38 / $7.11