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Illinois rates for HCPCS J1595

Injection, glatiramer acetate, 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $120.00 / $201.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $74.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.12 / $292.79 / $2,034.11
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
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.62 / $532.00 / $615.00
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.57 / $46.57 / $47.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.50 / $62.50 / $83.56