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Tetracycline Injection

California rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Rates data updated July 2026.

Facilitymedian $37 · 10th–90th $23$520%20%40%10th90th$37Professionalmedian $14 · 10th–90th $13$400%50%10th90th$14$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$32.36
Typical High
$83.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$13.80
Typical High
$23.99
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$39.81
Typical High
$52.48
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$190.55
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$39.81
Typical High
$398.11
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$16.60
Median
$16.60
Typical High
$16.60
Providence
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$19.95
Typical High
$38.02
Providence
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$33.11
Typical High
$79.43
United
Setting
Professional
Modifier
Global
Typical Low
$4.90
Median
$4.90
Typical High
$4.90