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Kansas 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
$75.17 / $2,177.53 / $22,930.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $46.22 / $63.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.26 / $55.60 / $77.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $48.98 / $48.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.75 / $42.75 / $45.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.31 / $45.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.30 / $55.92 / $89.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.80 / $47.80 / $76.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.31 / $72.50