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South Carolina rates for HCPCS J0121

Injection, omadacycline, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $5.62 / $17.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.98 / $6.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.75 / $4.57 / $7.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $5.13 / $6.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.89 / $4.27 / $4.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.27 / $4.27 / $4.27
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.37 / $5.25 / $10.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.89 / $4.17 / $8.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $4.17 / $4.57