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West Virginia rates for HCPCS J0696

Injection, ceftriaxone sodium, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.47 / $7.59 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $2.45 / $4.57
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.65 / $0.65
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.44 / $0.46 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $16.60 / $16.60
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.62 / $1.62 / $63.10
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.51 / $0.59 / $0.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.46 / $13.18