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Ohio 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 / $12.24 / $18.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.77 / $15.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.09 / $9.08 / $16.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $9.50
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.64 / $5.64 / $9.59
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $7.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.32 / $5.32 / $5.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $10.31
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $10.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.20 / $7.13 / $8.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $6.10