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Wisconsin rates for HCPCS J0390

Injection, chloroquine HCl, up to 250 mg

Facilitymedian $17 · 10th–90th $16–$440%50%10th90th$17Professionalmedian $17 · 10th–90th $16–$220%50%10th90th$17$20.0$50.0$100.0$200.0$500.0

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
$15.85 / $16.60 / $16.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $16.60 / $19.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $17.78 / $25.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $43.65 / $63.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $20.42 / $22.91
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $16.60 / $16.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $16.60 / $16.60
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $20.89 / $26.92
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $54.95 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $20.89 / $28.18