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Rhode Island rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.51 / $29.51 / $29.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $15.14 / $15.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $15.14 / $15.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $16.98