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North Carolina rates for HCPCS J1953

Injection, levetiracetam, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $75.86 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $37.15 / $467.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.19 / $0.66 / $0.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.12 / $0.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.07
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.09 / $0.11
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $2,570.40 / $3,630.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.08 / $0.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.07
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00