go back

West Virginia 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
$45.77 / $75.17 / $20,260.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.77 / $50.34
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.31 / $47.80 / $67.97
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.05 / $105.05 / $105.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.75 / $45.31 / $89.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.31 / $85.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.31 / $45.31 / $104.77