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Arizona rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.89 / $29.70 / $44.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.32 / $18.04 / $37.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.44 / $51.14 / $81.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.92 / $14.43 / $94.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.00 / $14.84 / $14.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.84 / $14.84 / $14.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.55 / $19.68 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.91 / $14.91 / $16.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.85 / $14.85 / $20.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $14.85 / $14.85