go back

West Virginia rates for HCPCS J0400

Injection, aripiprazole, intramuscular, 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.25 / $0.25 / $0.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.25 / $0.41 / $0.71
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $0.75 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $1.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $0.86 / $0.86