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Minnesota rates for HCPCS J0390

Injection, chloroquine HCl, up to 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.72 / $20.72 / $20.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.57 / $17.20 / $20.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.95 / $19.05 / $31.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.70 / $13.37 / $13.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.32 / $57.33 / $69.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.18 / $21.12 / $22.86
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.74 / $52.32 / $65.66
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.00 / $18.00 / $24.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.43 / $28.02 / $35.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.72 / $20.72 / $28.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.72 / $20.72 / $31.87