go back

Tetracycline Injection

Utah rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Rates data updated October 2026.

How much rates vary

Facilitymedian $14 · 10th to 90th $14 to $14Professionalmedian $14 · 10th to 90th $14 to $14
$20$50$100facility $14professional $14

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$13.80
Median
$13.80
Typical High
$13.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$13.80
Median
$13.80
Typical High
$13.80
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$97.72
Typical High
$97.72