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Maryland rates for HCPCS J1562

Injection, immune globulin (Vivaglobin), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.31 / $10.31 / $11.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.31 / $11.52 / $14.23
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.25 / $7.25 / $7.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.76 / $11.34 / $14.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $14.40 / $16.13