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Montana rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Facilitymedian $15 · 10th–90th $15–$280%50%10th90th$15Professionalmedian $15 · 10th–90th $15–$400%50%90th$15$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $39.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $16.22
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $16.22
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $42.66
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $42.66
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $16.22
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $21.88 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14