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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
$5,011.87 / $5,128.61 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $5,370.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,122.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $4,677.35 / $4,897.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $4,897.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,348.96 / $4,897.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $4,897.79 / $5,128.61