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Delaware 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
$122.15 / $3,529.60 / $28,080.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $47.53 / $5,820.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.52 / $47.52 / $47.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $71.30 / $112.80