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Georgia 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
$117.53 / $117.53 / $1,281.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.28 / $117.53 / $117.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.91 / $157.77 / $355.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.00 / $134.52 / $134.52
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.36 / $123.90 / $242.84
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.58 / $202.00 / $334.00
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,363.12 / $2,363.12 / $3,850.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.00 / $118.00 / $141.60