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Illinois rates for HCPCS J0275

Alprostadil urethral suppository (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.36 / $59.06 / $91.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.36 / $39.36 / $41.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.67 / $77.50 / $501.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.72 / $25.72 / $25.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.86 / $25.72 / $26.69
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.88 / $100.00 / $200.00
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.87 / $71.44 / $75.80