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Arizona rates for HCPCS J1726

Injection, hydroxyprogesterone caproate, (Makena), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $42.66 / $85.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $19.95 / $1,288.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $56.23 / $83.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $38.90 / $93.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.38 / $28.18 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $19.50 / $19.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.80 / $13.80 / $22.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $19.50 / $19.50