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Pennsylvania rates for HCPCS J0691

Injection Lefamulin 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.70 / $1.05 / $1.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.70 / $0.70 / $1.89
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.57 / $0.68 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.70 / $0.70 / $0.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.70 / $0.70 / $0.70
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.70 / $1.05 / $1.74
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.70 / $0.70 / $1.81
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.70 / $0.70 / $0.70
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.70 / $0.70 / $0.70
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.84
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.94