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Michigan 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
$48.95 / $49.83 / $155.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $48.95 / $58.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.21 / $103.65 / $197.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.99 / $48.41 / $48.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.03 / $47.52 / $47.52
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.53 / $71.30 / $138.65
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $48.95 / $57.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.65 / $55.26 / $55.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.53 / $47.53 / $47.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $53.23 / $57.99