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Utah rates for HCPCS J1364

Injection, erythromycin lactobionate, per 500 mg

Facilitymedian $158 · 10th–90th $23–$1950%20%40%10th90th$158Professionalmedian $23 · 10th–90th $20–$810%20%40%10th90th$23$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $194.98 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $22.91 / $75.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $30.90 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $144.54 / $331.13
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $81.28 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95