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Texas 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 / $48.42 / $94.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.36 / $40.35 / $43.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.80 / $156.97 / $313.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.19 / $70.19 / $70.19
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.00 / $95.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.30 / $41.83 / $60.59
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.90 / $41.83 / $49.57
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.86 / $40.35 / $60.59
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.86 / $25.72 / $41.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.58 / $71.44 / $71.44
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.72 / $25.72 / $34.72