go back

Nebraska 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 / $94.59 / $108.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.36 / $39.36 / $66.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.75 / $29.12 / $29.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.37 / $28.25 / $29.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.86 / $21.86 / $21.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.86 / $26.63 / $40.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.45 / $41.83 / $74.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.58 / $71.44 / $71.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.00 / $40.40 / $82.90
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.27 / $40.40 / $82.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.58 / $71.44 / $71.44