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North Carolina rates for HCPCS J0257

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.15 / $6.62 / $9.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.15 / $5.64 / $6.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.93 / $9.66 / $11.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.34 / $5.34 / $6.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.32 / $5.64 / $5.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $7.92
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.15 / $6.71 / $8.69
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.92 / $3.92 / $3.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $7.33
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $85.00 / $100.00