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Pennsylvania rates for HCPCS J0456

Injection, azithromycin, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.16 / $6.03 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $5.25
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.91 / $2.24 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $2.14 / $2.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.55 / $3.55
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $19.50 / $158.49
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $6.46 / $107.15
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $6.17
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.34 / $2.95 / $3.89
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $2.95 / $3.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $3.72