go back

Idaho 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
$47.80 / $3,924.72 / $8,634.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $49.85 / $8,018.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.75 / $45.31 / $45.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.31 / $45.31
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.85 / $60.04 / $81.00
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.40 / $45.31 / $56.64
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.31 / $45.31 / $69.05
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.02 / $54.38 / $54.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.31 / $63.43