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Indiana rates for HCPCS J2250

Injection Midazolam Hydrochloride Per 1 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $9.35 / $86.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.16 / $2.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.16 / $0.30 / $0.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.15 / $0.21
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.23
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.26