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Colorado rates for HCPCS J1097

Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.28 / $113.28 / $437.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.28 / $113.28 / $113.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.89 / $207.18 / $377.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.36 / $120.36 / $120.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.36 / $120.36 / $120.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.36 / $120.36 / $120.36
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.28 / $113.28 / $168.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.00 / $118.00 / $118.00