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Washington rates for HCPCS J1570

Injection, ganciclovir sodium, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.49 / $79.23 / $169.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.54 / $43.50 / $48.02
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.54 / $43.39 / $360.55
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.09 / $39.54 / $86.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.29 / $37.29 / $64.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.54 / $39.54 / $48.50
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.54 / $49.53 / $82.24
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.39 / $71.70 / $71.70
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.20 / $33.09 / $86.40
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.54 / $39.54 / $79.92
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.54 / $39.54 / $39.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.54 / $39.54 / $39.54