go back

Utah rates for HCPCS J0694

Injection, cefoxitin sodium, 1 g

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $74.13 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $3.98 / $5.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $6.76 / $7.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $4.79
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $3.72 / $6.61
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.27 / $4.79 / $5.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $4.79