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Alaska rates for HCPCS J1580

Injection, garamycin, gentamicin, up to 80 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.80 / $42.25 / $129.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $2.45 / $6.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $2.21 / $2.21
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.88 / $5.88 / $5.88
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $2.21 / $7.12
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.73 / $5.11 / $8.02
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.12 / $5.88 / $10.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $2.21 / $2.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $3.32 / $4.46