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Hawaii rates for HCPCS J0122

Injection, eravacycline, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.12 / $2.12 / $2.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.33 / $1.33
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $1.77 / $1.77
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.43 / $1.56 / $1.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $1.45 / $1.95
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.05 / $1.35 / $1.56