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Minnesota rates for HCPCS J0133

Acyclovir Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.04 / $23.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.11 / $1.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.07 / $0.12 / $0.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.05
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.11 / $0.14
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.06 / $0.57
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.07