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Oklahoma rates for HCPCS J1595

Injection Glatiramer Acetate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.75 / $60.75 / $120.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.75 / $60.75 / $60.75
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 / $67.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.14 / $75.00 / $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