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Iowa rates for HCPCS J0289

Amphotericin B Liposome Inj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.14 / $61.14 / $62.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $37.96 / $69.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.74 / $25.92 / $29.67
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $33.29 / $136.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.00 / $27.97 / $61.14
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.00 / $22.62 / $39.39
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.90 / $35.97 / $55.99
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.05 / $27.60 / $45.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $21.48 / $22.12
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.62 / $22.62 / $22.62
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.62 / $22.62 / $22.62