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Idaho rates for HCPCS J1364

Erythro Lactobionate /500 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.05 / $75.05 / $302.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $75.05 / $90.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.96 / $64.62 / $64.62
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
$3.29 / $80.77 / $115.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.95 / $64.62 / $80.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.95 / $65.95 / $65.95
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.78 / $104.67 / $177.94
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.54 / $77.54 / $80.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62