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Massachusetts 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
$6.34 / $35.54 / $187.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.97 / $6.16
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.63 / $14.64 / $75.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $9.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.13 / $6.10 / $13.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.78 / $4.78 / $4.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $4.78
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.69 / $53.00 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $10.13
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.91 / $13.84 / $29.16
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $9.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $9.24