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Illinois 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 / $4.28 / $7.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.11 / $2.11 / $2.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.80 / $8.36 / $35.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $5.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.24
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.42 / $4.62 / $345.40
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.67 / $2.67 / $2.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.38