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Maryland rates for HCPCS J1573

Injection Hepatitis B Immune Globulin (Hepagam B) Intravenous 0.5ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.66 / $71.66 / $71.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $96.02
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.43 / $85.43 / $85.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $84.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $100.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $75.70
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.94 / $65.94 / $65.94