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North Dakota 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 / $45.31 / $86.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.77 / $57.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.16 / $49.41 / $50.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.79 / $49.33 / $49.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.16 / $46.16 / $53.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.98 / $45.98 / $57.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.15 / $47.80 / $123.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.80 / $53.54 / $53.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $50.75 / $57.61