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North Carolina rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.62 / $17.30 / $26.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.62 / $14.85 / $19.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $24.41 / $30.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.76 / $15.76 / $15.76
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 / $23.11
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.62 / $17.67 / $24.81
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.98 / $12.98 / $12.98
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 / $23.02
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $85.00