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Arizona rates for HCPCS J1557

Injection, immune globulin, (Gammaplex), intravenous, nonlyophilized (e.g., liquid), 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.14 / $125.74 / $191.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.70 / $75.59 / $140.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.94 / $211.42 / $333.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.25 / $55.64 / $405.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.08 / $63.68 / $63.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.68 / $63.68 / $63.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.87 / $82.45 / $113.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.47 / $62.47 / $68.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.68 / $63.68 / $63.68