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Louisiana rates for HCPCS J1364

Injection, erythromycin lactobionate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.26 / $78.80 / $165.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $65.26 / $90.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.78 / $4.26 / $108.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.56 / $72.56 / $74.01
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.96 / $60.96 / $64.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $134.99