go back

Pennsylvania rates for HCPCS J0490

Injection, belimumab, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.07 / $131.06 / $18,380.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.07 / $62.29 / $6,035.70
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.71 / $60.83 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.18 / $58.18 / $58.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.89 / $56.07 / $56.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.07 / $56.07 / $56.07
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.22 / $68.33 / $180.80
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.57 / $137.47 / $18,380.06
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.07 / $67.77 / $5,533.84
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.89 / $56.07 / $56.07
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.07 / $56.07 / $56.07
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.20 / $50.20 / $58.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.20 / $50.20 / $58.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.07 / $56.07 / $96.64