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Pennsylvania rates for HCPCS J2791

Rhophylac Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.53 / $196.81 / $1,402.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.86 / $12.39 / $185.89
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.48 / $5.27 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $5.04 / $5.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.58 / $4.86 / $4.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.86 / $4.86 / $4.86
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.25 / $31.55 / $85.08
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.97 / $194.14 / $1,205.09
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $12.39 / $180.92
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.58 / $4.86 / $4.86
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.86 / $4.86 / $4.86
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.98 / $4.98 / $5.77
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.98 / $4.98 / $5.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.86 / $4.86 / $8.89