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Washington rates for HCPCS J1630

Injection Haloperidol Up To 5 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.88 / $3.20 / $69.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.88 / $1.45
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.80 / $1.82 / $100.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $1.31 / $3.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.80 / $0.98
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.80 / $1.00 / $1.98
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $2.99 / $2.99
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.19 / $1.39 / $3.60
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.80 / $0.80 / $0.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.80 / $0.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.80 / $0.96