go back

Maryland rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.14 / $14.14 / $14.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.14 / $14.14 / $18.10
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.47 / $19.47 / $19.47
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.00 / $36.00 / $36.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.10 / $15.10 / $15.10