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Texas rates for HCPCS J2425

Injection Palifermin 50 Micrograms

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.54 / $54.41 / $77.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.90 / $50.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.09 / $53.00 / $105.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.76 / $25.76 / $25.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.54 / $35.54 / $35.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $35.54
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $174.20 / $177.75
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.35 / $35.90 / $52.37
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.93 / $35.54 / $64.48
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.75 / $35.54 / $51.35
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.61 / $35.54 / $61.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $35.54
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.99 / $33.99 / $47.99