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Illinois rates for HCPCS J1558

Injection Immune Globulin (Xembify) 100 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.85 / $23.68 / $38.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $14.91 / $18.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.77 / $58.90 / $291.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.84 / $14.84 / $14.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.84 / $14.84 / $14.84
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $22.28 / $49.08
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.30 / $19.30 / $19.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $16.63 / $19.64