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New York rates for HCPCS J0133

Acyclovir Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.06 / $35.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.05 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.05
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.60
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.06
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.04 / $0.04