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Virginia rates for HCPCS 80177

Levetiracetam

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.27 / $67.77 / $159.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.02 / $9.94 / $13.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.25 / $13.25 / $64.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.54 / $6.54 / $8.01
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.35 / $58.61 / $87.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.71 / $31.28 / $67.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.51 / $8.84 / $15.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.90 / $16.55 / $19.61
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.66 / $9.66 / $18.43
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.63 / $18.09 / $18.66
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.31 / $18.09 / $4,071.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.31 / $18.09 / $4,071.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.57 / $7.60 / $13.25