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Utah rates for HCPCS J0401

Injection, aripiprazole (Abilify Maintena), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.94 / $7.94 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $7.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $10.00 / $10.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.23 / $12.88 / $25.12
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.59 / $7.59
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.61 / $7.24 / $8.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24