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Wisconsin rates for HCPCS J1645

Injection, dalteparin sodium, per 2500 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $22.39 / $44.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $14.13 / $25.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.62 / $18.62 / $18.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $19.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.79 / $35.48 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $19.05 / $27.54
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $16.60 / $16.60
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.76 / $33.11 / $33.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $18.20 / $18.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $18.20 / $29.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $16.22 / $50.12
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.79 / $14.79 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $14.79
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $21.38 / $26.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $16.22 / $16.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $22.39