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New Mexico 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 / $8.90 / $8.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $7.16 / $12.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $22.10 / $36.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.15 / $5.15 / $6.74
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.09 / $4.09 / $4.09
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.03 / $5.64 / $5.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.64