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West Virginia 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
$63.09 / $64.31 / $115.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.09 / $63.68 / $64.31
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.68 / $95.52 / $95.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.08 / $63.68 / $113.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.68 / $63.68 / $102.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.68 / $63.68 / $137.97