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Washington rates for HCPCS J0720

Injection, chloramphenicol sodium succinate, up to 1 g

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.98 / $61.66 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $47.86 / $51.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $50.12 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.69 / $41.69 / $41.69
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.98 / $48.98 / $50.12
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $50.12 / $52.48
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12
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 / $48.98