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Nebraska rates for HCPCS J1570

Injection, ganciclovir sodium, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.61 / $57.49 / $87.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.64 / $39.54 / $66.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.58 / $44.77 / $44.77
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.53 / $44.32 / $44.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.70 / $39.54 / $40.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.28 / $100.62 / $360.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.09 / $39.61 / $59.43
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.49 / $49.41 / $77.05
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.09 / $60.59 / $121.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.56 / $39.54 / $43.49