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Arizona rates for HCPCS J1364

Injection, erythromycin lactobionate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.14 / $129.24 / $193.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.08 / $90.81 / $201.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.04 / $230.56 / $375.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $72.65 / $411.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.30 / $87.74 / $118.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.05 / $75.05 / $75.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62