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Pennsylvania rates for HCPCS J2353

Injection Octreotide Depot Form For Intramuscular Injection 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$203.58 / $560.21 / $17,919.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.58 / $214.32 / $11,231.55
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$187.74 / $220.87 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.27 / $211.27 / $211.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$192.06 / $203.58 / $203.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.58 / $203.58 / $203.58
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.33 / $411.41 / $486.22
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.32 / $645.09 / $17,919.36
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.58 / $234.11 / $6,810.48
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$192.06 / $203.58 / $203.58
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.58 / $203.58 / $203.58
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$205.65 / $205.65 / $238.63
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.65 / $205.65 / $238.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.58 / $215.79 / $295.19