go back

Idaho rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $15.14 / $17.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.85 / $18.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $16.98 / $24.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $16.98 / $24.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $15.14 / $15.14
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 / $18.62
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $18.62
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $15.14 / $28.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $18.20 / $18.20
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $15.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $16.98