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Wisconsin rates for HCPCS J1180

Injection Dyphylline Up To 500 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $16.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.59 / $9.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.07 / $8.07 / $11.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.84 / $19.82 / $28.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.25 / $8.50 / $10.31
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $7.59
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.54 / $4.54 / $4.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $7.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.49 / $9.49 / $12.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $7.59
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.54 / $4.54 / $4.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.49 / $9.49 / $12.34