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Michigan rates for HCPCS J0720

Injection, chloramphenicol sodium succinate, up to 1 g

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.70 / $46.70 / $145.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.70 / $46.70 / $50.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.80 / $82.51 / $156.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.86 / $37.75 / $37.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.56 / $49.62 / $49.62
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.70 / $58.38 / $129.94
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.70 / $51.57 / $61.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.65 / $48.65 / $58.38