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Utah rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.98 / $48.98 / $48.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $48.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $61.66 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $87.10 / $154.88
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $45.71 / $45.71
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $42.66 / $51.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66