go back

Missouri rates for HCPCS J0200

Injection, alatrofloxacin mesylate, 100 mg

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $15.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $16.98 / $194.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $19.95 / $21.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.94 / $7.94 / $19.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $19.95 / $20.42