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Iowa 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
$94.29 / $115.66 / $140.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.68 / $104.84 / $140.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.88 / $64.88 / $64.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.58 / $58.58 / $73.22
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.68 / $84.17 / $179.37
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.47 / $66.78 / $115.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $68.97 / $85.47
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.91 / $85.16 / $115.82
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.77 / $65.86 / $86.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.68 / $71.31 / $75.66
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.47 / $62.47 / $62.47
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.47 / $62.47 / $62.47