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Delaware rates for HCPCS J1569

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.31 / $111.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.31 / $45.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $67.97 / $102.67