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Pennsylvania rates for HCPCS J1569

Gammagard Liquid Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.27 / $145.31 / $35,844.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $50.34 / $6,186.60
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.79 / $49.16 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.02 / $47.02 / $49.16
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
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.42 / $56.69 / $84.79
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.27 / $3,230.87 / $26,324.19
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $52.10 / $5,784.60
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,081.26 / $13,229.17 / $16,643.16
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.75 / $45.31 / $45.31
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.31 / $45.31
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.55 / $45.55 / $52.86
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.55 / $45.55 / $52.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $50.75 / $78.09