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Wisconsin rates for HCPCS J0696

Ceftriaxone Sodium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $37.33 / $111.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $2.69 / $18.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $0.54 / $0.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.54
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.57 / $0.57 / $0.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $1.07 / $1.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.76 / $0.86
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.48 / $0.71
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.86 / $0.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $6.26 / $27.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.48 / $0.71
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.86 / $0.86
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.51 / $1.10
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.74 / $123.74 / $123.74
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $1.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.65