go back

Alaska rates for HCPCS J1458

Injection, galsulfase, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $3,311.31 / $3,311.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $512.86
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $616.60
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $1,659.59
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $831.76 / $1,318.26
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,380.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $512.86 / $562.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $776.25 / $2,089.30