go back

Utah rates for HCPCS J1956

Injection, levofloxacin, 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.94 / $31.31 / $151.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.94 / $2.94 / $2.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.33 / $2.45 / $2.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $2.54 / $2.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $2.54 / $2.54