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South 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
$40.35 / $40.35 / $163.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.35 / $40.35 / $41.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.86 / $25.72 / $25.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.86 / $25.72 / $25.72
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.40 / $41.83 / $54.53
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.00 / $16.00 / $41.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.02 / $61.02 / $76.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.58 / $71.44 / $71.44