go back

Ohio rates for HCPCS J0720

Injection, chloramphenicol sodium succinate, up to 1 g

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $100.00 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $47.86 / $60.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $93.33 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $54.95 / $87.10
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $20.42 / $20.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $77.62
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $77.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $63.10 / $72.44
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $70.79 / $120.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $48.98 / $52.48