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Iowa 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
$4.79 / $9.12 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $72.44 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $5.25 / $6.17
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $7.94 / $13.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.09 / $6.76 / $9.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $5.01 / $8.91
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.31 / $6.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $8.13 / $8.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $5.13
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.90 / $4.90 / $4.90