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Rhode Island 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
$460.20 / $460.20 / $603.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.28 / $113.28 / $120.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.36 / $125.08 / $132.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.44 / $127.44 / $127.44
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.00 / $118.00 / $118.00