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North Dakota 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 / $10.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $6.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.12 / $6.15 / $6.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.20 / $6.14 / $6.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.74 / $5.74 / $6.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.55 / $5.61 / $6.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.31 / $5.71 / $9.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.45 / $5.71 / $6.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $5.64 / $6.13