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Utah rates for HCPCS J1571

Injection, hepatitis B immune globulin (Hepagam B), intramuscular, 0.5 ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $70.79 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $93.33 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $69.18
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $154.88 / $251.19
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $72.44 / $75.86
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $66.07 / $83.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $77.62