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Oklahoma rates for HCPCS J1458

Injection, galsulfase, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.51 / $545.95 / $928.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.46 / $549.46 / $549.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.96 / $479.96 / $508.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.38 / $508.76 / $508.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$397.92 / $536.23 / $780.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$484.88 / $505.51 / $508.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.76 / $508.76 / $508.76