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West Virginia rates for HCPCS J1558

Injection, immune globulin (xembify), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.91 / $14.91 / $15.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.85 / $14.85 / $15.06
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.85 / $14.91 / $22.28
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.43 / $34.43 / $34.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.00 / $14.84 / $19.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.84 / $14.84 / $27.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.65 / $14.85 / $23.11