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Missouri 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 / $39.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.36 / $39.36 / $41.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.58 / $38.58 / $48.87
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 / $25.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.36 / $60.59 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.58 / $71.44 / $77.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.58 / $71.44 / $82.16