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Pennsylvania rates for HCPCS J1364

Erythro Lactobionate /500 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.62 / $159.11 / $228.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $65.26 / $201.35
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.59 / $70.09 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.06 / $67.06 / $67.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.96 / $64.62 / $64.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.80 / $138.80 / $228.15
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $75.80 / $228.15
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.96 / $64.62 / $64.62
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.57 / $83.57 / $96.97
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.57 / $83.57 / $96.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $111.37