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Nebraska rates for HCPCS J0400

Injection, aripiprazole, intramuscular, 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $1.65 / $1.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.31 / $0.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $0.85 / $0.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.82 / $0.85 / $0.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.59 / $0.86 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.86 / $0.95
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.42 / $0.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.57 / $0.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.82 / $0.86 / $0.86