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Arizona rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $79.43 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $44.67 / $97.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $77.62 / $158.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $83.18 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.69 / $54.95 / $75.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $41.69 / $41.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $42.66 / $70.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66