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California rates for HCPCS J2791

Injection, Rho D immune globulin (human), (Rhophylac), intramuscular or intravenous, 100 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $10.72 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $12.02 / $186.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.13 / $5.75 / $11.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $5.13 / $14.79
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.23 / $11.22 / $13.49
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $6.31 / $14.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.57 / $4.57 / $4.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $4.79
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.37 / $5.37 / $10.96
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $4.90 / $4.90
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.79 / $7.41 / $12.02
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $9.55
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $8.51 / $8.51
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $5.37 / $8.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $16.22 / $16.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $12.88