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West Virginia 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
$48.00 / $10,028.48 / $10,028.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $48.00 / $54.71
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.53 / $71.30 / $71.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.83 / $47.52 / $99.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.52 / $47.52 / $90.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $47.53 / $115.10