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Minnesota 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 / $95.60 / $19,981.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $48.94 / $8,018.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.46 / $60.78 / $117.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.24 / $47.80 / $47.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.99 / $54.16 / $153.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.43 / $58.39 / $59.40
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.16 / $46.16 / $51.09
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.98 / $45.98 / $54.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.80 / $80.78 / $103.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.80 / $53.54 / $80.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $50.75 / $89.05