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Washington, DC rates for HCPCS J1955

Injection Levocarnitine Per 1 Gm (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.61 / $68.50 / $92.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.61 / $23.61 / $23.61
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.61 / $47.54 / $80.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.27 / $22.27 / $23.61
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.07 / $20.07 / $23.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.61 / $23.61 / $38.27