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Pennsylvania rates for HCPCS J1943

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.25 / $7.63 / $9.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.25 / $3.28 / $7.49
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.99 / $3.52 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.37 / $3.37 / $3.37
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
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.29 / $6.49 / $9.91
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.25 / $3.29 / $9.91
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.06 / $3.24 / $3.24
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.24 / $3.24 / $3.24
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.97 / $2.97 / $3.45
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.97 / $2.97 / $3.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.25 / $3.25 / $4.49