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Utah rates for HCPCS J1580

Injection, garamycin, gentamicin, up to 80 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.56 / $50.29 / $119.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $19.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.89 / $3.53 / $3.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $2.21 / $2.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $2.21 / $2.21