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Texas 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
$66.64 / $112.19 / $156.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $67.31 / $98.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.29 / $212.95 / $424.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.97 / $82.97 / $82.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.87 / $66.64 / $66.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $66.64
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.77 / $333.20 / $400.46
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.91 / $71.66 / $98.16
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.75 / $66.64 / $120.78
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.68 / $66.64 / $96.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.97 / $66.64 / $119.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.64 / $66.64 / $66.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.31 / $74.64 / $74.64
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.94 / $65.94 / $89.96