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Indiana rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.99 / $34.32 / $67.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $14.99 / $14.99
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.84 / $29.68 / $39.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.62 / $14.85 / $21.08
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.85 / $14.85 / $20.05
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $14.85 / $17.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.84 / $14.84 / $36.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.97 / $14.84 / $39.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $16.63 / $18.48