go back

Idaho rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.40 / $41.40 / $47.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.40 / $46.73 / $53.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.07 / $42.48 / $42.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.73 / $56.29 / $75.93
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $53.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.00 / $78.00 / $78.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.90 / $62.90 / $106.92
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.97 / $50.97 / $53.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48