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Oklahoma rates for HCPCS J0400

Aripiprazole Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.25 / $0.25 / $0.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.25 / $0.25 / $0.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.37 / $0.75 / $0.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.25 / $0.76 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.86 / $0.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.53 / $0.53 / $0.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.86 / $0.86