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Louisiana rates for HCPCS J1562

Injection, immune globulin (Vivaglobin), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.88 / $9.32 / $12.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.88 / $8.88 / $9.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.68 / $13.68 / $20.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.68 / $13.68 / $13.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $14.40 / $16.13