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Utah rates for HCPCS J1569

Gammagard Liquid Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.56 / $4,473.24 / $21,613.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.56 / $52.56 / $8,523.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.35 / $63.86 / $70.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.31 / $45.31
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.31 / $45.31 / $124.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.31 / $50.75