go back

North Dakota rates for HCPCS J1595

Injection Glatiramer Acetate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $60.00 / $114.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $75.00 / $75.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.63 / $65.95 / $66.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.79 / $65.86 / $66.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.50 / $70.50 / $88.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $63.20 / $2,328.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.50 / $62.50 / $67.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.13 / $62.50 / $67.88