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North Carolina rates for HCPCS J1595

Injection, glatiramer acetate, 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.65 / $63.75 / $138.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.65 / $58.65 / $79.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.63 / $65.63 / $181.79
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 / $75.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.65 / $62.17 / $82.50
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,153.89 / $1,153.89 / $1,153.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.50 / $62.50 / $96.88
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,199.84 / $2,551.37 / $2,813.76