go back

Nebraska rates for HCPCS J1322

Injection, elosulfase alfa, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$306.80 / $593.30 / $682.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.68 / $308.68 / $645.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.08 / $331.99 / $349.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$329.94 / $343.85 / $349.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$292.00 / $292.00 / $292.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.48 / $308.68 / $374.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$280.91 / $306.79 / $1,469.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.94 / $306.80 / $356.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$315.52 / $440.89 / $589.91
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.20 / $352.72 / $615.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.25 / $308.68 / $339.55