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Wisconsin rates for HCPCS J0200

Alatrofloxacin Mesylate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.03 / $16.03 / $35.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.03 / $16.03 / $20.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.03 / $17.03 / $24.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $36.63 / $52.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.38 / $15.84 / $19.22
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.03 / $16.03 / $16.03
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.89 / $9.89 / $9.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.03 / $16.03 / $16.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.04 / $20.04 / $26.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.03 / $16.03 / $16.03
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.89 / $9.89 / $9.89
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $16.98 / $16.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.04 / $20.04 / $27.44