go back

Michigan 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
$68.64 / $73.81 / $230.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $68.64 / $86.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.97 / $194.51 / $367.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.54 / $84.54 / $88.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $86.53
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.64 / $106.79 / $205.38
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $68.64 / $86.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.64 / $66.64 / $66.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $74.64 / $81.30