go back

Idaho 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
$24.29 / $24.29 / $27.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.61 / $25.97 / $29.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.27 / $23.61 / $23.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.61 / $23.61 / $23.61
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.97 / $31.28 / $42.20
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.61 / $23.61 / $29.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.38 / $24.38 / $24.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.33 / $28.33 / $29.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.61 / $23.61 / $33.04