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Vermont rates for HCPCS J1557

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.68 / $63.68 / $107.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.09 / $72.09 / $72.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.08 / $65.06 / $108.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.68 / $63.68 / $63.68
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.08 / $65.06 / $108.45
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.68 / $63.68 / $63.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.06 / $71.31 / $117.28