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Washington rates for HCPCS J1956

Injection, levofloxacin, 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.79 / $5.08 / $89.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $2.54 / $2.79
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.54 / $8.61 / $100.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.17 / $2.54 / $5.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.39 / $2.39 / $2.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $2.54 / $3.11
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.96 / $2.54 / $5.88
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.85 / $8.86 / $8.86
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.85 / $2.17 / $10.19
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.54 / $2.54 / $2.54
Regence BlueShield
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