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Missouri rates for HCPCS J1096

Dexamethasone Lacrimal Ophthalmic Insert 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.49 / $192.00 / $201.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $106.02 / $192.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.93 / $175.00 / $369.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $128.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.11 / $97.11 / $102.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $102.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.49 / $161.65 / $697.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.27 / $101.49 / $117.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.93 / $102.93 / $102.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.50 / $102.94 / $128.37