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South Carolina 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
$7.76 / $501.19 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $5.01 / $173.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $5.13 / $8.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.31 / $14.79 / $26.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $6.76 / $11.22
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.13 / $5.75 / $13.80
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $5.37