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Rhode Island rates for HCPCS J1595

Injection, glatiramer acetate, 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.75 / $243.75 / $243.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $63.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.75 / $66.25 / $70.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.50 / $67.50 / $67.50
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 / $63.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.50 / $62.50 / $62.50