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Wisconsin rates for HCPCS J1559

Injection, immune globulin (Hizentra), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $21.88 / $43.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $14.13 / $25.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.20 / $18.20 / $32.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $14.45 / $18.62
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $19.95 / $21.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.45 / $16.98 / $37.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $18.62 / $26.92
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.33 / $14.45 / $31.62
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $28.84 / $28.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.33 / $14.13 / $31.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $15.85 / $28.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $14.45 / $42.66
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.45 / $14.45 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $14.45 / $14.45
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $19.50 / $23.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.49 / $13.49 / $14.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $16.22 / $21.88