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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
$45.45 / $83.34 / $127.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.54 / $46.73 / $54.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $108.68 / $211.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.55 / $40.07 / $270.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.53 / $42.48 / $42.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.40 / $54.65 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.40 / $41.40 / $41.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48