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Missouri rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.91 / $22.55 / $23.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $15.29 / $23.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.84 / $25.25 / $53.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $14.85 / $18.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.00 / $14.84 / $14.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.84 / $14.84 / $14.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.91 / $21.14 / $85.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $14.91 / $17.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.85 / $14.85 / $14.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $14.85 / $19.17