go back

Idaho rates for HCPCS J0200

Alatrofloxacin Mesylate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.04 / $20.04 / $20.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.03 / $17.03 / $20.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $16.98 / $16.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $16.98 / $16.98
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.03 / $18.26 / $24.64
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.00 / $78.00 / $78.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.75 / $42.75 / $52.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.04 / $20.04 / $22.94