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Idaho rates for HCPCS J1096

Dexamethasone Lacrimal Ophthalmic Insert 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.49 / $101.49 / $116.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.49 / $113.23 / $128.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.11 / $102.94 / $102.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $102.94
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.23 / $136.38 / $184.00
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $113.23 / $128.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.00 / $78.00 / $110.68
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.55 / $204.40 / $329.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.52 / $123.52 / $128.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $102.94