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Nebraska rates for HCPCS J1595

Injection, glatiramer acetate, 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $120.23 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $102.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $75.86 / $75.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $74.13 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $70.79 / $89.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $162.18 / $2,570.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $63.10 / $269.15
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $3,715.35 / $3,715.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $165.96 / $323.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $63.10 / $93.33