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South Carolina rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.60 / $44.60 / $175.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.13 / $44.60 / $44.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.13 / $53.62 / $85.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.18 / $53.10 / $58.62
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.60 / $53.37 / $107.95
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.36 / $73.36 / $73.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48