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Nebraska rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $22.39 / $30.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $39.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.18 / $16.60 / $17.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $16.60 / $16.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.49 / $19.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $22.39 / $85.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $14.79 / $16.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $21.88 / $21.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $15.14 / $28.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $15.85 / $16.98