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Iowa rates for HCPCS J1320

Injection Amitriptyline Hcl Up To 20 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.11 / $5.07 / $7.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.11 / $2.11 / $2.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $2.25 / $2.81
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.45 / $3.45 / $150.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.59 / $1.00 / $3.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.46
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.59 / $0.90 / $1.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $4.44 / $4.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.31