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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

Facilitymedian $155 · 10th–90th $120–$2820%20%10th90th$155Professionalmedian $120 · 10th–90th $112–$1820%50%10th90th$120$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $186.21 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $120.23 / $141.25
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $524.81
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $177.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $257.04 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $177.83
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $151.36 / $7,079.46
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $199.53
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $524.81
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $120.23 / $125.89