go back

Wisconsin rates for HCPCS J0745

Injection, codeine phosphate, per 30 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.05 / $1.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $1.95 / $3.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.95 / $3.63 / $5.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.70 / $1.95
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.93 / $1.35 / $2.14
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.07 / $2.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.93 / $1.35 / $2.14
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $2.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $64.57 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.58 / $2.34 / $3.31
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $158.49 / $158.49
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $1.66 / $3.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $0.98 / $0.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $2.09