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Ohio rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $87.10 / $5,248.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $56.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $79.43 / $223.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $47.86 / $75.86
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $57.54 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $40.74 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $69.18
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $40.74 / $42.66
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $69.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $53.70 / $61.66
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $74.13 / $102.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $46.77