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Nebraska rates for HCPCS J1320

Injection, amitriptyline HCl, up to 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.11 / $5.07 / $5.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.11 / $2.11 / $3.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.90 / $2.52 / $2.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.39 / $2.50 / $2.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.25 / $2.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.63 / $2.63 / $4.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.64
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.59 / $0.59 / $4.44
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $4.44 / $4.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.13 / $2.24 / $2.46