go back

Iowa rates for HCPCS J1562

Injection, immune globulin (Vivaglobin), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.63 / $27.68 / $32.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.63 / $8.63 / $8.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.50 / $9.38 / $9.38
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.82 / $22.76 / $150.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $14.40 / $18.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.76 / $15.24 / $17.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $11.76 / $15.93
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $12.77 / $23.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $15.12 / $16.13