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Pennsylvania rates for HCPCS J1097

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

Facilitymedian $240 · 10th–90th $120–$1,3180%10%10th90th$240Professionalmedian $120 · 10th–90th $112–$1200%50%10th$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 / $281.84 / $1,318.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $120.23 / $120.23
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $169.82
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $117.49 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $416.87 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $229.09 / $446.68
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $120.23 / $141.25
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $181.97 / $181.97
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $120.23 / $120.23
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,162.28 / $5,754.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $97.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $162.18