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Illinois rates for HCPCS J0400

Aripiprazole Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $1.09 / $1.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.33 / $0.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.80 / $2.15 / $10.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.75
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.63 / $120.00 / $345.40
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.53 / $0.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.86 / $0.91