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Pennsylvania rates for HCPCS J0691

Injection, lefamulin, 1 mg

Facilitymedian $1 · 10th–90th $1–$20%20%10th90th$1Professionalmedian $1 · 10th–90th $1–$10%20%40%10th90th$1$0.5$5.0$50.0$500.0$5.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.05 / $1.38 / $1.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.05 / $1.38 / $1.82
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.58 / $0.68 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.68 / $0.68 / $0.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.71 / $2.45 / $2.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $0.71 / $0.71
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.72 / $0.72 / $0.72
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.05 / $1.05 / $1.05
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.05 / $1.05 / $1.05
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.49 / $0.72 / $0.98
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.49 / $0.83 / $1.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.72 / $0.72 / $0.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.68 / $0.68 / $0.93