go back

Vermont rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $71.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.09 / $48.09 / $48.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.07 / $48.41 / $80.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.07 / $48.41 / $80.69
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $45.19