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Arizona rates for HCPCS J1568

Injection, immune globulin, (Octagam), intravenous, nonlyophilized (e.g., liquid), 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.86 / $95.06 / $1,339.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.00 / $59.88 / $6,282.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.87 / $166.44 / $273.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.20 / $46.83 / $310.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.83 / $47.52 / $47.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.52 / $47.52 / $47.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.29 / $76.09 / $99.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.38 / $48.38 / $53.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $47.53 / $47.53