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Montana rates for HCPCS J1556

Injection, immune globulin (Bivigam), 500 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.15 / $93.50 / $184.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.23 / $88.23 / $208.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.39 / $77.39 / $88.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.23 / $88.23 / $208.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.39 / $83.96 / $109.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.39 / $77.39 / $77.39