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Minnesota rates for HCPCS J1364

Injection, erythromycin lactobionate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.62 / $64.62 / $150.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $201.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.30 / $97.68 / $171.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.04 / $75.05 / $80.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.27 / $212.13 / $258.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.87 / $78.14 / $85.34
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $193.58 / $242.96
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.20 / $67.20 / $91.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.22 / $29.86 / $126.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.05 / $75.05 / $119.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $119.81