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Kansas rates for HCPCS J0694

Injection Cefoxitin Sodium 1 Gm (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.39 / $76.40 / $394.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.88 / $6.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.28 / $7.21 / $16.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.07 / $6.07 / $6.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.51 / $4.51 / $4.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $4.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.24 / $7.82 / $9.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $5.13 / $7.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $8.13