go back

Texas rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.40 / $69.31 / $165.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.90 / $56.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.54 / $102.61 / $204.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.79 / $45.79 / $45.79
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $212.40 / $213.85
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.40 / $42.90 / $62.56
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.05 / $42.48 / $78.41
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.07 / $42.48 / $61.35
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.04 / $42.48 / $76.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $43.32 / $57.35