go back

North Dakota 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
$3.98 / $3.98 / $8.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $72.44 / $173.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $5.25 / $5.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $5.25 / $5.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $4.90 / $6.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.90 / $8.32 / $19.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $5.01 / $5.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $4.79 / $5.37