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Washington, DC rates for HCPCS J1569

Injection, immune globulin, (Gammagard liquid), nonlyophilized, (e.g., liquid), 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.31 / $134.80 / $181.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.31 / $45.31
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.32 / $70.16 / $118.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.75 / $42.75 / $45.31
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.51 / $38.51 / $45.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.86 / $45.31 / $58.83