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Tetracycline Injection

Michigan rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Rates data updated July 2026.

Facilitymedian $23 · 10th–90th $13$370%20%10th90th$23Professionalmedian $13 · 10th–90th $1$180%50%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
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$23.44
Typical High
$37.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$18.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$18.20
Typical High
$18.20
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$2.63
Median
$37.15
Typical High
$41.69
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$1.07
Median
$1.29
Typical High
$14.13
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$18.20
Typical High
$18.20