go back

North Dakota rates for HCPCS J0200

Injection, alatrofloxacin mesylate, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.03 / $16.03 / $36.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.03 / $20.04 / $20.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.38 / $15.53 / $19.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.03 / $16.03 / $48.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.04 / $20.04 / $21.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.03 / $20.04 / $21.76