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Iowa rates for HCPCS J1364

Erythro Lactobionate /500 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.44 / $101.44 / $165.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $101.44 / $201.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.20 / $79.15 / $84.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.72 / $64.62 / $306.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $90.06 / $104.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.02 / $75.05 / $104.55
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $90.06 / $133.29
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.57 / $90.06 / $136.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $65.91
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.05 / $75.05 / $75.05
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.05 / $75.05 / $75.05