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Iowa rates for HCPCS J0288

Ampho B Cholesteryl Sulfate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.75 / $147.75 / $250.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.53 / $67.53 / $67.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.63 / $18.28 / $18.28
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.48 / $44.59 / $52.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.00 / $24.65 / $134.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.00 / $16.00 / $124.58
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $91.93 / $124.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $93.26 / $183.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.00 / $16.00 / $16.48