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Indiana rates for HCPCS J1364

Injection, erythromycin lactobionate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.26 / $156.91 / $404.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $65.26 / $75.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.84 / $129.24 / $193.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.92 / $64.62 / $91.76
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.62 / $64.62 / $96.93
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $80.78
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 / $179.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $107.66