go back

Louisiana rates for HCPCS J0401

Injection, aripiprazole (Abilify Maintena), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $7.59 / $18.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $7.94
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $6.17 / $6.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.76 / $7.76 / $7.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.76 / $7.76 / $7.94
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $6.92 / $7.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $7.24 / $7.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.24 / $7.94