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New Jersey rates for HCPCS J0289

Injection, amphotericin B liposome, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $31.62 / $56.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $28.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.50 / $25.12 / $32.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $20.89 / $20.89
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $7,762.47 / $23,988.33
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $23.44 / $23.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $28.18 / $58.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $20.89 / $24.55