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Louisiana rates for HCPCS J1556

Injection, immune globulin (Bivigam), 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.27 / $79.70 / $170.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.27 / $78.16 / $93.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.39 / $42.08 / $80.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.56 / $80.56 / $82.17
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.01 / $73.01 / $77.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.39 / $77.39 / $77.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.39 / $77.39 / $90.32