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Alaska rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $97.72 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $28.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $48.98
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $32.36 / $51.29
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $14.79
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $39.81
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $16.22 / $60.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $22.39 / $44.67