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Idaho rates for HCPCS J1562

Injection, immune globulin (Vivaglobin), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.22 / $8.22 / $8.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.08 / $10.55 / $12.79
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.55 / $12.79 / $16.37
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.14 / $8.14 / $9.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.00 / $78.00 / $78.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.58 / $14.24 / $20.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $14.40 / $16.13