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Arizona rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.80 / $33.28 / $49.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.48 / $13.48 / $16.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.18 / $46.26 / $73.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.70 / $11.20 / $74.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.48 / $19.28 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.81 / $18.36 / $18.36