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Wisconsin rates for HCPCS J0401

Inj Aripiprazole Ext Rel 1mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.45 / $14.12 / $16.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.49 / $14.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.10 / $13.47 / $16.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $9.24
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.96 / $9.96 / $11.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.28 / $17.16 / $24.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $10.63 / $12.08
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.97 / $7.24 / $15.67
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.86 / $14.56 / $14.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.97 / $7.24 / $15.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $14.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.03 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.97 / $7.24 / $15.67
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.86 / $14.56 / $14.56
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.27 / $8.86 / $22.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $7.28
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.84 / $10.22 / $10.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $9.97