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Illinois rates for HCPCS J0696

Injection, ceftriaxone sodium, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.81 / $25.54 / $195.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $1.96 / $10.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.45 / $3.98 / $10.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.60 / $0.60
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
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $1.12 / $35.57
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.56