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Michigan rates for HCPCS J0696

Injection, ceftriaxone sodium, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.12 / $14.45 / $45.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $1.80 / $5.47
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.00 / $48.00 / $48.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.51 / $0.97 / $1.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.57 / $0.57 / $0.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $1.26
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.88 / $9.51 / $70.15
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $1.00 / $7.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.55 / $0.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.44