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Minnesota rates for HCPCS J0288

Ampho B Cholesteryl Sulfate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.40 / $79.40 / $79.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.08 / $67.53 / $79.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.68 / $21.56 / $37.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.98 / $14.98 / $14.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.07 / $46.58 / $56.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.77 / $17.16 / $18.57
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.35 / $42.51 / $53.35
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.63 / $14.63 / $19.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.51 / $17.67 / $114.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.00 / $16.00 / $22.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.00 / $16.00 / $28.80