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Nebraska rates for HCPCS J1990

Injection, chlordiazepoxide HCl, up to 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.05 / $50.57 / $58.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.05 / $21.05 / $35.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.87 / $23.83 / $23.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.64 / $23.59 / $23.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.05 / $21.75 / $27.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.05 / $40.00 / $109.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.05 / $21.05 / $26.31
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.06 / $25.81 / $38.08
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.06 / $33.90 / $51.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $21.05 / $23.16