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West Virginia rates for HCPCS J1595

Injection, glatiramer acetate, 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.20 / $63.20 / $63.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.25 / $63.75 / $63.75
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,338.37 / $1,381.96 / $2,418.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.75 / $63.75 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.75 / $63.75 / $118.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.50 / $62.50 / $215.28