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Arkansas rates for HCPCS J1595

Injection Glatiramer Acetate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.75 / $63.75 / $63.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.25 / $62.25 / $63.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.50 / $57.50 / $57.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.50 / $57.50 / $57.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.75 / $63.75 / $120.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.75 / $63.75 / $63.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.50 / $62.50 / $194.14