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West Virginia rates for HCPCS J0287

Injection Amphotericin B Lipid Complex 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.40 / $10.40 / $11.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.30 / $10.30 / $10.40
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.30 / $15.45 / $15.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.72 / $10.30 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.30 / $10.30 / $26.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.30 / $10.30 / $12.60