go back

Oregon rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.64 / $16.64 / $33.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.81 / $13.81 / $16.64
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.81 / $19.75 / $29.69
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79,999.20 / $79,999.20 / $79,999.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.81 / $19.75 / $2,400,000.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$477.11 / $477.11 / $477.11