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Ohio rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $25.70 / $41.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $20.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $23.99 / $53.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $16.98 / $27.54
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.79 / $14.79 / $14.79
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $14.13 / $15.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $29.51
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $14.13 / $15.14
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.55 / $15.14 / $29.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $18.62 / $21.38
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $25.70 / $35.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.79 / $15.14 / $15.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $15.14 / $18.20