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Utah rates for HCPCS J1630

Injection, haloperidol, up to 5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $21.88 / $47.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $2.09 / $21.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.89 / $1.58 / $1.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.72
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.81 / $1.23
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.79 / $0.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.81