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Delaware rates for HCPCS J0133

Injection, acyclovir, 5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $144.54 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.12
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.87 / $0.87 / $1.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.10 / $0.12 / $0.18