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Arizona rates for HCPCS J1595

Injection, glatiramer acetate, 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.25 / $150.00 / $225.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.75 / $60.75 / $72.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.73 / $223.00 / $353.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.25 / $60.00 / $397.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.75 / $63.75 / $63.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.75 / $63.75 / $63.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.75 / $86.40 / $2,199.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.50 / $62.50 / $62.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.50 / $62.50 / $62.50