go back

West Virginia rates for HCPCS J0390

Injection, chloroquine HCl, up to 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $16.98 / $17.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $16.98 / $19.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $18.62 / $18.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $20.89 / $20.89