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Indiana rates for HCPCS J0257

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.70 / $13.39 / $25.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.70 / $5.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.64 / $11.28 / $14.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $5.64 / $8.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.64 / $5.64 / $8.46
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $7.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.64 / $5.64 / $13.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.09 / $5.64 / $15.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $7.05