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Indiana 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 / $39.36 / $177.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.36 / $39.36 / $41.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.53 / $25.72 / $49.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.86 / $25.72 / $35.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,874.72 / $32,812.17 / $39,374.61
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34,124.66 / $34,124.66 / $34,124.66
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 / $40.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.58 / $71.44 / $71.44