go back

North Carolina rates for HCPCS J0200

Alatrofloxacin Mesylate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.03 / $17.03 / $22.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.63 / $17.03 / $19.96
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 / $20.04
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.03 / $18.05 / $22.04
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.04 / $19.04 / $19.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.04 / $20.04 / $26.05
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00