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Pennsylvania rates for HCPCS J0401

Injection, aripiprazole (Abilify Maintena), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $14.45 / $44.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $10.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $7.94 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.59 / $7.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $12.59 / $12.59
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.41 / $13.80 / $21.88
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.24 / $19.05
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.46 / $7.94 / $8.51
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $8.51 / $11.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $10.00