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Utah 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
$29.53 / $29.53 / $35.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.53 / $29.53 / $29.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.44 / $46.40 / $49.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.46 / $25.46 / $25.46
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.69 / $68.11 / $97.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.46 / $25.46 / $28.52