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Washington rates for HCPCS J0257

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.02 / $9.65 / $11.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $6.20 / $7.13
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.35 / $6.64 / $12.95
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.98 / $7.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.32 / $5.32 / $13.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $6.92
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.64 / $7.05 / $11.88
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.82 / $8.56 / $14.99
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.41 / $5.98 / $7.70
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.31 / $6.20 / $10.78
Regence BlueShield
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