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Tetracycline Injection

Louisiana rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Rates data updated October 2026.

How much rates vary

Facilitymedian $17 · 10th to 90th $17 to $17Professionalmedian $17 · 10th to 90th $3 to $17
$5$10facility $17professional $17

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$16.60
Median
$16.60
Typical High
$16.60
Aetna
Setting
Professional
Modifier
None
Typical Low
$16.60
Median
$16.60
Typical High
$16.60
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$8.32
Median
$8.32
Typical High
$8.32
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$3.31
Median
$3.31
Typical High
$3.31
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$2.51
Median
$2.51
Typical High
$2.51
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$1.66
Median
$1.66
Typical High
$1.66
United
Setting
Professional
Modifier
None
Typical Low
$3.24
Median
$3.24
Typical High
$3.31