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Michigan rates for HCPCS J0288

Injection, amphotericin B cholesteryl sulfate complex, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.64 / $72.34 / $217.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.64 / $71.73 / $72.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.03 / $24.38 / $46.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.60 / $14.00 / $17.25
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.40 / $72.34 / $201.29
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.00 / $16.20 / $72.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.00 / $16.00 / $16.98