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Tetracycline Injection

Idaho rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Rates data updated July 2026.

Facilitymedian $17 · 10th–90th $17$200%50%90th$17Professionalmedian $14 · 10th–90th $13$170%50%10th90th$14$20.0$50.0$100.0

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

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$16.60
Typical High
$16.60
Aetna
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$14.13
Typical High
$16.60
BCBS
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$14.45
Typical High
$20.42
Molina
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15