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Wyoming 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
$47.86 / $47.86 / $47.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $46.77 / $81.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $117.49 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $44.67 / $44.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $47.86 / $67.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $47.86 / $95.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $47.86 / $52.48