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Tennessee rates for HCPCS J1562

Injection, immune globulin (Vivaglobin), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.68 / $11.28 / $17.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.68 / $8.77 / $9.74
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.98 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.68 / $14.40 / $16.13