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Idaho rates for HCPCS J0696

Injection, ceftriaxone sodium, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.64 / $13.16 / $148.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $1.28 / $4.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.43 / $0.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $3.51 / $27.44
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $1.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.52 / $0.52 / $0.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.69