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Maryland rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.91 / $14.91 / $14.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $14.85 / $19.98
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.84 / $14.84 / $14.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.84 / $14.84 / $18.91
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $14.85 / $20.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $14.85 / $16.87
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.26 / $14.26 / $14.26