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Nebraska rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $67.61 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $114.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $48.98 / $48.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $46.77 / $48.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $43.65 / $54.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.69 / $79.43 / $213.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $41.69 / $45.71
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $66.07 / $66.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $42.66 / $85.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $42.66 / $56.23