go back

Wisconsin rates for HCPCS J1330

Injection Ergonovine Maleate Up To 0.2 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.18 / $8.18 / $8.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.87 / $4.87 / $6.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.87 / $9.83 / $14.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.13 / $4.25 / $5.16
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.73 / $5.73 / $5.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.73 / $5.73 / $5.73
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.73 / $5.73 / $7.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.73 / $5.73 / $5.73
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$455.75 / $455.75 / $455.75
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.87 / $4.87 / $4.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.73 / $5.73 / $7.85