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Pennsylvania rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.82 / $96.88 / $125.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.82 / $42.90 / $50.09
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.17 / $46.08 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.08 / $44.08 / $44.08
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
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.82 / $96.88 / $125.86
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.82 / $42.90 / $125.86
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.07 / $42.48 / $42.48
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.41 / $41.41 / $48.05
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.41 / $41.41 / $48.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $58.66