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North Carolina 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
$54.01 / $78.34 / $113.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.01 / $63.68 / $93.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.81 / $97.88 / $156.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.67 / $41.67 / $66.59
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 / $137.97
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.01 / $75.78 / $147.36
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.25 / $37.25 / $37.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.68 / $63.68 / $98.70
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.28 / $117.28 / $318.39