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Washington rates for HCPCS J1571

Hepagam B Im Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.48 / $121.05 / $180.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $73.31 / $95.35
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.78 / $94.17 / $182.06
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $71.53 / $106.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.87 / $62.87 / $159.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $81.73
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.64 / $83.30 / $149.05
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.66 / $95.39 / $166.93
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.69 / $71.53 / $106.79
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.78 / $75.34 / $169.05
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $66.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $74.64