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Wyoming rates for HCPCS J0696

Injection, ceftriaxone sodium, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.98 / $66.12 / $301.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $4.65 / $47.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.36 / $1.60 / $1.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43