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Utah rates for HCPCS J2791

Injection, Rho D immune globulin (human), (Rhophylac), intramuscular or intravenous, 100 IU

Facilitymedian $263 · 10th–90th $102–$5250%10%20%10th90th$263Professionalmedian $5 · 10th–90th $4–$1380%20%10th90th$5$5.0$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $263.03 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $5.62 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.62 / $6.92 / $11.75
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $4.79 / $4.79
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.01
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.37 / $4.79 / $5.75
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $4.79 / $4.79