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Massachusetts 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
$120.36 / $196.82 / $324.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.36 / $120.36 / $120.36
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.35 / $112.35 / $818.35
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.00 / $118.00 / $177.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.34 / $171.65 / $365.89
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.42 / $153.91 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.36 / $120.36 / $249.96
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.50 / $139.50 / $521.65
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.00 / $118.00 / $177.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.00 / $118.00 / $177.00