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Idaho 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
$48.38 / $48.38 / $55.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $51.80 / $59.41
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
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.28 / $62.97 / $84.96
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.88 / $47.53 / $59.41
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.53 / $47.53 / $71.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.45 / $57.03 / $57.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $47.53 / $56.68