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Nebraska 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 / $101.83 / $129.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.70 / $46.70 / $85.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.67 / $54.05 / $56.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.04 / $56.32 / $56.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.03 / $49.62 / $51.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.38 / $88.73 / $218.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.79 / $48.65 / $58.38
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.17 / $49.55 / $55.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.17 / $49.55 / $90.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.22 / $48.65 / $53.52