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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
$5.75 / $9.55 / $14.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $5.01 / $7.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.75 / $26.92 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.75 / $5.75 / $5.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $5.75 / $5.75
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.62 / $8.51 / $19.05
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
$7.41 / $7.41 / $7.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.68 / $4.68 / $8.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $5.75 / $6.31