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Tennessee 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 / $62.89 / $102.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $47.53 / $58.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.55 / $116.55 / $116.55
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.07 / $237.65 / $240.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $47.53 / $97.84