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Kansas rates for HCPCS J0390

Injection, chloroquine HCl, up to 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $16.60 / $16.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $19.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.39 / $23.99 / $23.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $20.89 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $20.89 / $20.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $20.89 / $20.89