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Pennsylvania rates for HCPCS J0565

Injection, bezlotoxumab, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.83 / $93.20 / $8,109.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.83 / $40.22 / $103.88
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.72 / $43.21 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.33 / $41.33 / $41.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.57 / $39.83 / $39.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.83 / $39.83 / $39.83
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.22 / $79.26 / $8,109.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.83 / $41.82 / $121.08
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.57 / $39.83 / $39.83
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.83 / $39.83 / $39.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.90 / $39.90 / $46.29
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.90 / $39.90 / $46.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.83 / $39.83 / $56.25