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Arizona rates for HCPCS J0696

Injection, ceftriaxone sodium, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.10 / $7.84 / $90.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $2.27 / $8.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.42 / $1.51 / $2.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.46 / $2.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.53 / $1.72 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43