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Louisiana rates for HCPCS J0841

Injection, crotalidae immune F(ab')2 (equine), 120 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,045.15 / $1,083.26 / $2,307.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,044.14 / $1,055.59 / $1,263.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$988.20 / $1,147.91 / $1,334.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,147.91 / $1,147.91 / $1,170.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$985.99 / $985.99 / $1,045.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,045.15 / $1,045.15 / $1,045.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,273.13 / $1,273.13 / $1,273.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,045.15 / $1,045.15 / $1,584.00