go back

Arizona rates for HCPCS J1562

Injection, immune globulin (Vivaglobin), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.45 / $28.80 / $43.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.61 / $9.61 / $11.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.25 / $7.25 / $7.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.57 / $14.40 / $18.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $14.40 / $15.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $14.40 / $14.40