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Kansas 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
$42.57 / $42.57 / $246.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.82 / $50.82 / $63.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.55 / $65.59 / $85.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.02 / $58.02 / $58.02
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.59 / $50.82 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.94 / $52.94 / $62.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.94 / $52.94 / $63.53