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Louisiana rates for HCPCS J2792

Injection Rho D Immune Globulin Intravenous Human Solvent Detergent 100 Iu (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.71 / $32.31 / $68.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.46 / $25.71 / $37.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.24 / $9.66 / $35.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.76 / $35.76 / $36.47
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.02 / $24.02 / $25.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.46 / $25.46 / $25.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.46 / $25.46 / $32.92