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South Carolina rates for HCPCS J1558

Injection Immune Globulin (Xembify) 100 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.59 / $15.59 / $63.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.62 / $15.59 / $24.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.97 / $22.58 / $36.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.44 / $20.34 / $25.24
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 / $14.84
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.59 / $18.71 / $36.32
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.28 / $23.28 / $23.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $14.85 / $16.63