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Pennsylvania rates for HCPCS J0456

Azithromycin

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.93 / $6.48 / $167.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.06 / $10.56
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.42 / $2.84 / $1,023.29
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.88 / $2.21 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.11 / $2.11 / $2.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.92 / $2.04 / $2.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.40 / $107.11 / $158.30
Independence Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.42 / $2.76 / $982.48
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.00 / $6.89 / $128.69
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.64 / $7.93
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.92 / $2.04 / $2.04
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.57 / $2.57 / $2.98
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.57 / $2.57 / $2.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $3.73