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Ohio rates for HCPCS J0401

Injection, aripiprazole (Abilify Maintena), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.28 / $15.80 / $5,512.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.34 / $20.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.86 / $12.71 / $20.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $12.27
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.28 / $7.28 / $12.38
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $9.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.86 / $6.86 / $7.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $11.31
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.33 / $14.33 / $14.33
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $11.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.96 / $9.10 / $10.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $7.87