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West Virginia rates for HCPCS J1364

Injection, erythromycin lactobionate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.26 / $75.05 / $75.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $75.80
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.62 / $96.93 / $96.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.96 / $64.62 / $86.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $131.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $157.71