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Iowa rates for HCPCS J0390

Injection, chloroquine HCl, up to 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.57 / $39.83 / $61.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.57 / $16.57 / $16.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.00 / $18.00 / $22.50
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $381.69 / $381.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $3.13 / $29.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.72 / $20.72 / $21.34
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $1.00 / $3.13
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.13 / $3.13 / $3.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.72 / $20.72 / $21.34