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Ohio rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Facilitymedian $28 · 10th–90th $13–$420%10%10th90th$28Professionalmedian $13 · 10th–90th $1–$170%20%10th90th$13$1.0$2.0$5.0$10.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $28.18 / $41.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $13.18 / $16.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.15 / $1.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $50.12 / $50.12
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26