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Pennsylvania rates for HCPCS J1555

Injection, immune globulin (Cuvitru), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.84 / $41.16 / $53.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.84 / $17.01 / $36.72
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.53 / $18.27 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.48 / $17.48 / $18.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.89 / $16.84 / $16.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.84 / $16.84 / $16.84
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.76 / $30.01 / $53.47
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.84 / $17.76 / $53.47
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.89 / $16.84 / $16.84
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.84 / $16.84 / $16.84
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.06 / $15.06 / $17.47
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.06 / $15.06 / $17.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.84 / $18.86 / $24.42