go back

Pennsylvania rates for HCPCS J1301

Injection, edaravone, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.03 / $44.09 / $57.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.99 / $21.20 / $1,362.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.35 / $22.77 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.78 / $21.78 / $21.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.80 / $20.99 / $20.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.99 / $20.99 / $20.99
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.03 / $37.49 / $57.27
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.03 / $21.83 / $57.27
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.80 / $20.99 / $20.99
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.99 / $20.99 / $20.99
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.41 / $21.41 / $24.85
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.41 / $21.41 / $24.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.99 / $20.99 / $28.99