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Nebraska rates for HCPCS J1555

Injection, immune globulin (Cuvitru), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $26.30 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $17.38 / $44.67
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.38 / $17.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.79 / $19.05 / $19.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $19.05 / $19.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.78 / $21.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $27.54 / $85.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $17.78 / $19.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $25.70 / $25.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $17.38 / $33.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $18.20 / $19.50