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Tennessee rates for HCPCS J0390

Injection, chloroquine HCl, up to 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $22.39 / $30.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $16.98 / $16.98
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $151.36 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $20.89 / $20.89