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Michigan rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $30.20 / $47.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $22.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $24.55 / $60.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $15.49 / $15.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $20.89 / $20.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $40.74 / $47.86
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.49 / $20.42
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $14.79 / $15.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $16.98 / $17.78