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Pennsylvania rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Facilitymedian $24 · 10th–90th $14–$400%20%10th90th$24Professionalmedian $14 · 10th–90th $13–$140%50%10th$14$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$14.13 / $25.70 / $39.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $14.13 / $14.13
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.91 / $10.47 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $10.47 / $10.47
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $21.38 / $22.39
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $14.13 / $14.13