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Hawaii rates for HCPCS J1580

Injection, garamycin, gentamicin, up to 80 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.32 / $7.00 / $29.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $2.76 / $4.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.32 / $5.32 / $5.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $2.21 / $2.21
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.61 / $3.61 / $3.61
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.43 / $2.65 / $3.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $2.96 / $3.32
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.90 / $2.62 / $3.60