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Tetracycline Injection

Wisconsin rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Rates data updated July 2026.

Facilitymedian $13 · 10th–90th $13$300%50%90th$13Professionalmedian $13 · 10th–90th $13$170%50%10th90th$13$2.0$5.0$10.0$20.0$50.0

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
$13.18
Median
$13.18
Typical High
$29.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$16.60
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$33.88
Typical High
$33.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$24.55
Typical High
$41.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$11.48
Typical High
$12.88
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$13.18
Medica
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$13.18
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$54.95
Typical High
$85.11
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$13.18
United
Setting
Professional
Modifier
Global
Typical Low
$8.13
Median
$10.23
Typical High
$12.02