go back

Montana rates for HCPCS J1559

Injection, immune globulin (Hizentra), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.63 / $17.09 / $28.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.10 / $15.10 / $31.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.34 / $14.34 / $15.10
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.10 / $15.10 / $31.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.34 / $15.56 / $20.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.34 / $14.34 / $14.34