go back

Arizona rates for HCPCS J1458

Injection, galsulfase, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$544.37 / $1,017.52 / $1,526.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$556.05 / $611.66 / $1,063.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$422.42 / $1,744.61 / $2,763.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.69 / $469.36 / $3,236.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.96 / $508.76 / $508.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.76 / $508.76 / $508.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$494.62 / $644.98 / $795.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.51 / $505.51 / $505.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.76 / $508.76 / $508.76