go back

Pennsylvania rates for HCPCS J0291

Injection, plazomicin, 5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.50 / $8.35 / $10.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $3.54 / $8.15
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.23 / $3.80 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.64 / $3.64 / $3.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.31 / $3.50 / $3.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $3.50 / $3.50
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.61 / $7.10 / $10.85
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $3.61 / $10.85
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.31 / $3.50 / $3.50
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $3.50 / $3.50
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.44 / $3.44 / $3.99
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.44 / $3.44 / $3.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $3.50 / $4.94