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Kansas rates for HCPCS J0288

Ampho B Cholesteryl Sulfate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.06 / $72.06 / $94.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.08 / $72.06 / $94.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $19.98 / $23.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.80 / $16.80 / $16.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.00 / $14.00 / $14.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.00 / $14.00 / $14.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.35 / $16.00 / $107.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.00 / $16.00 / $16.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.00 / $16.00 / $16.64