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Michigan rates for HCPCS J0850

Injection, cytomegalovirus immune globulin intravenous (human), per vial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.90 / $1,863.73 / $6,728.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,808.65 / $1,862.90 / $2,189.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,235.83 / $4,027.74 / $7,619.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,750.63 / $1,842.77 / $1,842.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,088.52 / $1,808.65 / $1,808.65
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,808.65 / $2,712.98 / $5,814.84
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,808.65 / $1,862.90 / $2,170.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,808.65 / $2,025.69 / $2,170.38