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Michigan rates for HCPCS J0257

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.81 / $5.88 / $18.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.81 / $6.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.54 / $12.29 / $23.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.44 / $5.73 / $5.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $5.64 / $5.64
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.64 / $7.90 / $16.36
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.81 / $6.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.26 / $6.48 / $6.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.98