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Illinois 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 / $232.22 / $611.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.28 / $113.28 / $141.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.34 / $348.49 / $2,043.38
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
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.00 / $124.70 / $251.00
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.24 / $115.24 / $118.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.00 / $118.00 / $127.44