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Pennsylvania rates for HCPCS J0515

Injection Benztropine Mesylate Per 1 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.33 / $40.40 / $112.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.33 / $15.48 / $45.25
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.14 / $16.63 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.90 / $15.90 / $15.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.46 / $15.32 / $15.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.32 / $15.32 / $15.32
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.53 / $46.53 / $46.53
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.44 / $40.40 / $88.78
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.33 / $17.44 / $52.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.46 / $15.32 / $15.32
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.32 / $15.32 / $15.32
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.46 / $17.46 / $20.26
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.46 / $17.46 / $20.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.33 / $15.33 / $26.96