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Wisconsin rates for HCPCS J1096

Dexamethasone Lacrimal Ophthalmic Insert 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.53 / $197.91 / $233.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $106.02 / $174.36
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.68 / $190.42 / $229.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $130.72
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.94 / $140.94 / $164.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.94 / $318.08 / $454.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $116.15 / $140.94
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.49 / $101.49 / $226.67
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.24 / $205.88 / $205.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.49 / $101.49 / $223.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.49 / $101.49 / $205.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $85.00 / $270.06
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.49 / $101.49 / $226.67
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.24 / $205.88 / $205.88
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $136.88 / $383.90
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$697.75 / $697.75 / $697.75
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $102.94
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.53 / $144.53 / $144.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.93 / $102.93 / $102.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $154.41