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New Jersey 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
$6.31 / $89.13 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $5.13 / $181.97
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $28.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.79 / $5.62 / $7.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $4.79
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.18 / $11,481.54 / $25,703.96
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.13 / $5.13 / $5.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $9.33 / $9.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $5.50