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Idaho 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 / $257.04 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $5.01 / $6.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $7.24 / $15.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $7.76 / $15.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.57 / $4.79 / $4.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $4.79
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.79 / $6.03 / $269.15
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $6.03 / $7.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $5.25 / $5.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $5.75 / $6.03
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $10.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $7.76