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Nebraska rates for HCPCS J1364

Injection, erythromycin lactobionate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.05 / $75.05 / $142.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $75.05 / $201.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.86 / $69.48 / $73.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.48 / $73.15 / $84.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $67.20 / $84.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.78 / $180.95 / $378.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.95 / $75.05 / $112.58
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.63 / $94.90 / $157.52
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.48 / $90.06 / $191.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.39 / $64.62 / $71.08