go back

Pennsylvania rates for HCPCS J1460

Injection Gamma Globulin Intramuscular 1 Cc (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.91 / $102.65 / $147.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.91 / $49.52 / $112.48
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.22 / $53.20 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.88 / $50.88 / $50.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.26 / $49.03 / $49.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.03 / $49.03 / $49.03
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.66 / $158.66 / $158.66
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.91 / $82.66 / $147.19
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.91 / $49.52 / $147.19
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.26 / $49.03 / $49.03
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.03 / $49.03 / $49.03
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.87 / $47.87 / $55.55
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.87 / $47.87 / $55.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.03 / $49.03 / $63.98