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New Mexico rates for HCPCS J0121

Injection Omadacycline 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.01 / $6.25 / $6.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.18 / $8.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.09 / $4.09 / $4.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.09 / $4.09 / $4.09
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.80 / $4.09 / $4.09
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.09 / $4.09 / $4.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.01 / $4.01 / $4.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.01 / $4.01