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Missouri rates for HCPCS J1580

Injection, garamycin, gentamicin, up to 80 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.82 / $19.05 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.51 / $6.61
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $2.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $2.29 / $5.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.19 / $2.19 / $2.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $2.19 / $2.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.19 / $2.19 / $2.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.63 / $4.37 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.63 / $3.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.45 / $3.31 / $3.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.19 / $2.69