go back

North Dakota 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 / $135.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $90.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.09 / $70.45 / $71.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.59 / $70.34 / $70.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.20 / $67.20 / $84.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.05 / $87.33 / $127.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.95 / $75.05 / $81.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.93 / $64.62 / $72.37