go back

Idaho rates for HCPCS J1943

Injection, aripiprazole lauroxil, (Aristada Initio), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.26 / $3.26 / $3.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.25 / $3.57 / $4.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.06 / $3.24 / $3.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.24 / $3.24 / $3.24
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.57 / $4.30 / $5.81
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.25 / $3.25 / $4.05
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.30 / $4.71 / $7.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $3.89 / $4.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.25 / $3.25 / $3.25