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West Virginia rates for HCPCS J0200

Injection, alatrofloxacin mesylate, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.03 / $17.03 / $17.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.63 / $17.03 / $17.03
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44,999.55 / $44,999.55 / $69,999.30
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 / $18.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.44 / $20.04 / $20.04