go back

Virginia rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.14 / $15.44 / $30.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.14 / $14.14 / $14.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.00 / $39.00 / $39.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.54 / $21.54 / $21.54