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Nebraska rates for HCPCS J1631

Injection Haloperidol Decanoate Per 50 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.68 / $8.19 / $10.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.40 / $4.68 / $39.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.74 / $4.98 / $4.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.73 / $4.98 / $5.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.40 / $4.69 / $5.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.89 / $23.35 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.21 / $4.68 / $7.02
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.53 / $9.19 / $22.29
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.62 / $18.78 / $38.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.18 / $4.40 / $4.84