go back

Alaska rates for HCPCS J1364

Injection, erythromycin lactobionate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.84 / $138.19 / $488.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.80 / $120.19 / $201.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.87 / $171.87 / $171.87
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $208.08
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.79 / $142.02 / $223.17
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.33 / $171.87 / $334.75
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $70.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $96.93 / $130.35