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Indiana rates for HCPCS J0390

Injection, chloroquine HCl, up to 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $16.60 / $74.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $16.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $58.88 / $66.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.38 / $28.84
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63,095.73 / $63,095.73 / $70,794.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $22.91 / $22.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $20.89 / $22.39