go back

Wisconsin rates for HCPCS J2407

Injection, oritavancin (Orbactiv), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.51 / $42.66 / $85.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $28.18 / $48.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $63.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $28.18 / $36.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $58.88 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $36.31 / $52.48
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $28.84 / $63.10
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $57.54 / $57.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $28.84 / $63.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $28.84 / $45.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $30.90 / $85.11
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $144.54
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $28.18 / $28.18
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $38.90 / $47.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.84 / $28.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $28.18 / $38.90