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Washington rates for HCPCS J1364

Injection, erythromycin lactobionate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.08 / $126.77 / $160.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $71.08 / $101.24
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.78 / $104.67 / $216.32
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $67.41 / $101.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.96 / $60.96 / $131.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $79.25
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.62 / $84.01 / $156.10
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.66 / $84.20 / $184.97
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.96 / $71.52 / $101.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.78 / $87.33 / $196.39
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62