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Missouri rates for HCPCS J0289

Injection, amphotericin B liposome, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $61.66 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $20.89 / $61.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $22.39 / $57.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $21.38 / $26.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.50 / $20.89 / $20.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $20.89 / $21.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.39 / $60.26 / $131.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $22.39 / $27.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.78 / $28.18 / $30.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $20.89 / $25.70