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Massachusetts 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 / $5.64 / $11.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.86 / $6.85
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.18 / $15.12 / $85.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $7.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.05 / $7.20 / $15.34
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.82 / $53.00 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $11.71
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $85.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $8.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $7.90