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North Dakota rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.85 / $14.85 / $26.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $14.85 / $18.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.11 / $16.19 / $16.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.69 / $16.17 / $16.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.11 / $15.11 / $17.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.55 / $14.70 / $18.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.00 / $22.28 / $44.73
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.91 / $16.70 / $16.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $16.63 / $18.82