go back

Massachusetts 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
$41.83 / $41.83 / $86.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.83 / $41.83 / $41.83
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.85 / $86.12 / $100.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.58 / $64.30 / $71.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.57 / $31.58 / $69.95
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 / $33.28
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.72 / $25.72 / $51.44
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.00 / $100.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.58 / $71.44 / $95.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.58 / $71.44 / $87.92