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Texas rates for HCPCS J1555

Injection, immune globulin (Cuvitru), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.84 / $29.73 / $38.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.84 / $17.01 / $24.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.20 / $38.47 / $72.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.30 / $17.30 / $17.30
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $85.00 / $85.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.01 / $24.08 / $24.81
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.19 / $16.84 / $30.49
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.89 / $16.84 / $24.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.90 / $16.84 / $30.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.82 / $16.82 / $16.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.31 / $18.86 / $18.86
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.61 / $16.61 / $22.73