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Pennsylvania rates for HCPCS J1632

Injection Brexanolone 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.98 / $113.99 / $188.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.98 / $75.98 / $75.98
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.07 / $74.20 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.20 / $74.20 / $74.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.98 / $75.98 / $75.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.98 / $75.98 / $75.98
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.98 / $113.99 / $188.46
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.98 / $75.98 / $151.22
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.98 / $75.98 / $75.98
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.98 / $75.98 / $75.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.00 / $72.00 / $72.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.50 / $74.50 / $97.22