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Montana rates for HCPCS J0257

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

Facilitymedian $6 · 10th–90th $5–$280%20%40%10th90th$6Professionalmedian $6 · 10th–90th $5–$150%50%10th90th$6$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.75 / $14.79
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.31 / $46,773.51 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $6.17 / $14.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.62 / $5.62 / $6.17
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.57 / $5.75 / $16.22
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $5.75 / $16.22
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $6.17 / $14.13
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.62 / $7.94 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $5.75 / $5.75