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Wisconsin rates for HCPCS J0691

Injection Lefamulin 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $1.40 / $1.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.66 / $0.66 / $1.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.33 / $1.55 / $1.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.68 / $1.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.70 / $1.70 / $2.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $1.09 / $1.24
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $0.72 / $0.72
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.08 / $1.08 / $1.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $0.72 / $0.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.00 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $0.72 / $0.72
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.08 / $1.08 / $1.08
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.70 / $0.70 / $0.70
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.01 / $1.01 / $1.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.88