go back

Hawaii rates for HCPCS J0289

Injection, amphotericin B liposome, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.80 / $51.80 / $51.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.81 / $51.81 / $51.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $21.48 / $21.48
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.01 / $35.01 / $35.01
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.63 / $25.78 / $30.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $28.77 / $32.22
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.52 / $30.65 / $32.26