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Utah rates for HCPCS J0390

Injection, chloroquine HCl, up to 250 mg

Facilitymedian $17 · 10th–90th $17–$170%50%90th$17Professionalmedian $17 · 10th–90th $16–$200%50%10th90th$17$2.0$5.0$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $16.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $16.98 / $19.95
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $302.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $20.89 / $20.89