go back

Wisconsin rates for HCPCS J0400

Aripiprazole Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.35 / $0.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.64 / $1.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $1.79 / $2.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.63 / $0.94
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $0.71 / $0.76
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.26 / $1.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $0.71 / $0.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.86 / $1.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.36 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $0.71 / $0.76
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.26 / $1.13
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.77 / $1.08
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.75
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.69 / $0.69 / $0.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.86 / $1.18