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Hawaii rates for HCPCS J0696

Injection, ceftriaxone sodium, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.00 / $61.13 / $217.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $2.31 / $8.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.01 / $1.01 / $1.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.81 / $2.81 / $2.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.52 / $0.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.54 / $0.65
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.59 / $9.69