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North Carolina 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
$35.48 / $40.74 / $44.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $40.74 / $41.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $25.70 / $28.84
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.69 / $41.69 / $50.12
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $41.69 / $72.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.07 / $28.84 / $70.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $70.79 / $70.79
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00