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Pennsylvania rates for HCPCS J1726

Injection, hydroxyprogesterone caproate, (Makena), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.62 / $34.85 / $51.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.62 / $20.62 / $1,280.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.90 / $11.65 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.65 / $11.65 / $11.65
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.62 / $31.75 / $51.14
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.62 / $20.62 / $1,280.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.64 / $19.64 / $27.14