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Indiana rates for HCPCS J1458

Injection, galsulfase, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$510.56 / $1,163.40 / $2,297.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.76 / $513.85 / $513.85
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$508.76 / $1,017.52 / $1,348.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.44 / $508.76 / $722.43
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$508.76 / $508.76 / $763.14
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.76 / $508.76 / $635.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$508.76 / $508.76 / $1,112.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.80 / $508.76 / $1,333.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.76 / $508.76 / $630.86