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Washington 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
$41.83 / $41.83 / $98.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.36 / $41.83 / $49.01
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.52 / $95.00 / $100.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.43 / $58.88 / $75.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.86 / $25.72 / $102.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.86 / $25.72 / $26.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.82 / $62.50 / $74.96
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.72 / $25.72 / $79,999.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.01 / $71.44 / $71.44