go back

Indiana rates for HCPCS J1458

Injection, galsulfase, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $1,174.90 / $2,344.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $524.81 / $562.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $776.25 / $1,122.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $1,000.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $758.58 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $1,318.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $794.33 / $891.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $616.60