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Alaska rates for HCPCS J1573

Injection, hepatitis B immune globulin (Hepagam B), intravenous, 0.5 ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $69.18
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $69.18 / $83.18
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $223.87
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $147.91 / $234.42
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $72.44 / $72.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $128.82 / $186.21
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $70.79 / $75.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $104.71 / $478.63