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Wisconsin rates for HCPCS J1554

Injection Immune Globulin (Asceniv) 500 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$511.40 / $968.20 / $1,140.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.74 / $511.64 / $853.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$620.92 / $918.97 / $1,107.73
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.74 / $496.74 / $630.85
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$680.09 / $680.09 / $794.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.74 / $632.63 / $1,367.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.06 / $766.38 / $870.89
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.51 / $496.51 / $1,094.91
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$744.77 / $993.48 / $993.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.50 / $496.51 / $1,094.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.51 / $556.09 / $993.48
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.00 / $85.00 / $496.68
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.51 / $496.51 / $1,094.91
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$744.77 / $993.48 / $993.48
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.74 / $538.91 / $1,683.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,483.40 / $2,483.40 / $2,483.40
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.74 / $496.74 / $496.74
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.51 / $496.51 / $496.51
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$697.42 / $697.42 / $697.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.74 / $556.35 / $625.89