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Utah rates for HCPCS J1096

Dexamethasone Lacrimal Ophthalmic Insert 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.72 / $119.40 / $119.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.40 / $119.40 / $119.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.96 / $149.16 / $171.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $102.94
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.68 / $251.39 / $269.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.79 / $102.94 / $102.94