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Nebraska rates for HCPCS J1458

Injection, galsulfase, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.51 / $513.77 / $1,124.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.51 / $508.76 / $1,063.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$431.98 / $547.16 / $575.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$543.66 / $566.54 / $575.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.03 / $508.76 / $617.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$469.12 / $1,037.09 / $2,423.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$476.00 / $505.51 / $588.24
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$455.57 / $581.85 / $902.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$433.06 / $558.29 / $1,014.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$483.32 / $508.76 / $559.64