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Michigan rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.65 / $43.75 / $133.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $43.75 / $50.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.50 / $94.58 / $178.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.11 / $43.27 / $43.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.48 / $53.37 / $118.67
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.65 / $50.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.45 / $42.45 / $42.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $45.07