go back

Rhode Island rates for HCPCS J0289

Amphotericin B Liposome Inj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.81 / $69.81 / $69.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $21.48 / $22.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.62 / $22.62 / $51.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $21.48 / $21.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.27 / $21.48 / $21.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $21.48 / $21.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $21.48 / $21.48