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Pennsylvania rates for HCPCS J1595

Injection, glatiramer acetate, 20 mg

Facilitymedian $123 · 10th–90th $63–$2190%20%10th90th$123Professionalmedian $63 · 10th–90th $60–$630%50%10th$63$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $123.03 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $63.10 / $63.10
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $218.78 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $223.87 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $95.50 / $295.12
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $63.10 / $63.10
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $117.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $114.82