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Illinois 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 / $8.57 / $14.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.71 / $6.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.22 / $28.27 / $100.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.64
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $7.92 / $17.64
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.33 / $7.33 / $7.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $6.72