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Rhode Island rates for HCPCS J0257

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.32 / $18.32 / $18.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.71 / $5.71 / $6.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.64
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 / $5.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.64