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Utah rates for HCPCS J1554

Injection, immune globulin (Asceniv), 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $562.34 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $707.95 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $912.01 / $1,862.09
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $524.81 / $524.81
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $501.19 / $588.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $549.54