go back

New Mexico 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
$47.53 / $75.42 / $75.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $48.00 / $73.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.95 / $272.14 / $441.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.82 / $41.82 / $57.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.52 / $47.52 / $47.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.52 / $47.52 / $47.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.21 / $50.21 / $50.21
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.57 / $46.95 / $47.52
Providence
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 / $47.53 / $47.53