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Tetracycline Injection

Utah rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Rates data updated July 2026.

Facilitymedian $14 · 10th–90th $14$140%50%$14Professionalmedian $14 · 10th–90th $14$980%50%90th$14$20.0$100.0$500.0$2.0K

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
$13.80
Median
$13.80
Typical High
$13.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$13.80
Select Health
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,011.87
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72