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Iowa rates for HCPCS 80375

Drug/Substance Definitive Qual/Quant Nos 1-3

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.95 / $37.86 / $47.33
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.20 / $82.64 / $150.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.86 / $35.17 / $112.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $21.93 / $55.46
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.41 / $43.89 / $84.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.54 / $42.39 / $60.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.61 / $13.16 / $47.74
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.82 / $25.10 / $25.10