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Utah rates for HCPCS J0780

Prochlorperazine Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.50 / $35.11 / $73.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $2.00 / $11.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.46 / $4.16 / $5.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $1.81 / $1.81
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $2.92 / $16.57
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.99 / $2.45 / $2.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $1.81 / $1.81