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Alaska rates for HCPCS J1595

Injection, glatiramer acetate, 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.24 / $100.24 / $354.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.25 / $101.25 / $101.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.75 / $63.75 / $63.75
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.79 / $144.79 / $144.79
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,596.00 / $1,596.00 / $2,280.00
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.60 / $96.60 / $151.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.60 / $138.00 / $227.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.75 / $63.75 / $2,280.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.50 / $93.75 / $126.08