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Michigan rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Facilitymedian $37 · 10th–90th $13–$420%20%10th90th$37Professionalmedian $13 · 10th–90th $11–$170%20%40%10th90th$13$1.0$2.0$5.0$10.0$20.0$50.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $37.15 / $41.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $13.18 / $15.85
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.75 / $23.44 / $41.69
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.07 / $1.41 / $14.13
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20