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Indiana rates for HCPCS J0121

Injection Omadacycline 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.05 / $9.11 / $18.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.05 / $4.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.01 / $8.03 / $10.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.41 / $4.01 / $5.70
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.01 / $4.01 / $6.03
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.01 / $5.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.09 / $4.09 / $4.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.75 / $4.09 / $10.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.01 / $5.00