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Colorado rates for HCPCS J1572

Injection Immune Globulin (Flebogamma) Intravenous Non-Lyophilized (E.G. Liquid) 500mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.82 / $50.82 / $196.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.82 / $50.82 / $50.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.43 / $91.06 / $169.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.12 / $56.12 / $56.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.00 / $54.00 / $54.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.00 / $54.00 / $54.00
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.74 / $55.57 / $75.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.00 / $171.00 / $171.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.94 / $52.94 / $52.94