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Utah rates for HCPCS J1556

Injection, immune globulin (Bivigam), 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $177.83 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $109.65 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $134.90 / $275.42
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $83.18 / $89.13
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $77.62 / $95.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $89.13