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Wisconsin rates for HCPCS J0401

Injection, aripiprazole (Abilify Maintena), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.41 / $10.96 / $21.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $12.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.12 / $9.12 / $16.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $9.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $14.79 / $25.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.41 / $9.33 / $13.49
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.01 / $7.24 / $15.85
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $14.45 / $14.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.01 / $7.24 / $15.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $11.48
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $64.57 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.94 / $21.88
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $7.24 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $9.77 / $12.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $7.08 / $7.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $10.00