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Pennsylvania rates for HCPCS J0694

Injection, cefoxitin sodium, 1 g

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.01 / $74.88 / $387.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.83 / $19.28
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.41 / $5.19 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.96 / $4.96 / $4.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.51 / $4.78 / $4.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $4.78
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.86 / $69.06 / $100.07
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.79 / $67.50 / $412.16
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $5.19 / $15.60
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.51 / $4.78 / $4.78
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $4.78
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.87 / $4.87 / $5.65
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.87 / $4.87 / $5.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $8.75