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Pennsylvania rates for HCPCS J0696

Ceftriaxone Sodium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.94 / $9.00 / $428.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.50 / $2.11 / $6.95
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.52 / $0.61 / $447.63
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.53 / $0.53
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.40 / $0.47 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.45
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
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.15 / $12.30 / $165.81
Independence Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.52 / $0.59 / $429.78
Independence Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.53 / $0.53
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.46 / $9.60 / $457.60
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $2.08 / $7.97
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.43 / $0.43
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.53 / $0.53 / $0.61
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.53 / $0.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.91