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Texas rates for HCPCS J0696

Injection, ceftriaxone sodium, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.37 / $16.26 / $171.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.44 / $2.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.52 / $6.35 / $12.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.26 / $0.26
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $6.55 / $850.10
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.50 / $10.80
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.85 / $1.85 / $1.85
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.32 / $123.74 / $123.74
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.62 / $4.05 / $5.33
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.94 / $9.27 / $96.80
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.59 / $35.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.43 / $1.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.43 / $0.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.45 / $0.57