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Washington rates for HCPCS J0121

Injection Omadacycline 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $5.15 / $8.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.42 / $5.52
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.84 / $5.82 / $11.25
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.24 / $5.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.79 / $3.79 / $7.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.09 / $4.09 / $4.93
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.01 / $5.01 / $8.36
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.29 / $5.85 / $10.24
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.84 / $4.24 / $5.40
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.84 / $4.66 / $8.69
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.01 / $4.01
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