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Utah rates for HCPCS J0289

Injection, amphotericin B liposome, 10 mg

Facilitymedian $28 · 10th–90th $24–$660%20%40%10th90th$28Professionalmedian $23 · 10th–90th $20–$250%20%40%10th90th$23$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $23.99 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $23.99 / $26.92
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $31.62 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $22.91
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $46.77 / $75.86
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $23.44 / $23.44
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $22.91 / $25.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $20.89 / $20.89