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Nebraska rates for HCPCS J1562

Injection, immune globulin (Vivaglobin), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.66 / $27.68 / $31.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.66 / $8.66 / $14.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.16 / $8.21 / $8.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.79 / $8.13 / $8.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.50 / $7.50 / $9.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.40 / $16.45 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.96 / $14.40 / $16.13
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.87 / $11.65 / $17.20
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.58 / $15.24 / $23.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $16.13 / $16.13