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California rates for HCPCS 80177

Levetiracetam

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.02 / $22.50 / $111.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.02 / $9.65 / $15.38
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.63 / $7.95 / $9.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.52 / $31.96 / $293.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.54 / $11.34 / $20.97
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.97 / $80.50 / $166.43
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.22 / $11.74 / $63.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.98 / $17.39 / $44.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.69 / $15.83 / $20.53
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.78 / $13.25 / $21.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.60 / $13.25 / $29.15
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.00 / $62.94 / $62.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.95 / $7.95 / $7.95
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.27 / $13.44 / $33.13
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.81 / $13.25 / $20.53
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.50 / $46.50 / $46.50
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.60 / $12.02 / $16.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.57 / $7.60 / $26.33