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Hawaii rates for HCPCS J1322

Injection, elosulfase alfa, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$525.34 / $525.34 / $525.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.68 / $308.68 / $308.68
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$429.12 / $429.12 / $429.12
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$339.55 / $370.42 / $432.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.68 / $352.71 / $463.02
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.72 / $338.91 / $379.16