go back

Virginia rates for HCPCS 80376

Drug/Substance Definitive Qual/Quant Nos 4-6

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.93 / $8.93 / $11.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.18 / $59.55 / $69.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $14.92 / $45.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.24 / $34.85 / $35.67
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.50 / $24.28 / $28.57
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $22.98 / $22.98
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.89 / $29.45 / $7,420.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.89 / $29.45 / $7,420.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.06 / $13.33 / $25.52