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Florida 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 / $52.73 / $139.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.82 / $52.73 / $54.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $54.00 / $54.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.00 / $54.00 / $54.00
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.00 / $54.00 / $54.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $50.00 / $50.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.94 / $52.94 / $59.29
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.49 / $59.49 / $59.49