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Tetracycline Injection

Pennsylvania rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Rates data updated July 2026.

Facilitymedian $22 · 10th–90th $14$420%20%10th90th$22Professionalmedian $14 · 10th–90th $14$140%50%$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
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$22.39
Typical High
$41.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$14.13
Typical High
$14.13
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$8.91
Median
$10.47
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$10.47
Median
$10.47
Typical High
$10.47
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$21.88
Typical High
$39.81
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$14.13
Typical High
$36.31