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Alabama rates for HCPCS J1572

Injection, immune globulin, (Flebogamma/Flebogamma Dif), intravenous, nonlyophilized (e.g., liquid), 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.00 / $54.00 / $54.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.09 / $54.00 / $89.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,921.89 / $2,332.31 / $3,137.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.94 / $52.94 / $53.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.00 / $54.00 / $54.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.06 / $54.00 / $54.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.94 / $52.94 / $52.94