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Illinois rates for HCPCS J0200

Injection, alatrofloxacin mesylate, 100 mg

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $61.66 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $18.20 / $18.20
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $7.94 / $151.36
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $20.42