go back

Michigan rates for HCPCS J1320

Injection, amitriptyline HCl, up to 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.11 / $2.11 / $6.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.11 / $2.11 / $2.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.24
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.11 / $3.69 / $6.58
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.11 / $2.20 / $2.64
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.69