go back

Alaska rates for HCPCS J0720

Injection, chloramphenicol sodium succinate, up to 1 g

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.02 / $78.02 / $275.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.46 / $78.81 / $85.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.62 / $49.62 / $49.62
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.70 / $112.70 / $112.70
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.24 / $36.24 / $51.78
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.73 / $81.73 / $128.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.73 / $112.70 / $192.65
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.24 / $49.62 / $51.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.65 / $72.98 / $98.14