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Wisconsin rates for HCPCS J2460

Injection, oxytetracycline HCl, up to 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.95 / $1.95 / $1.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.26 / $2.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.93 / $0.93 / $1.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.93 / $2.29 / $3.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.26 / $1.45
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.87 / $0.87 / $0.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.87 / $0.87 / $0.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.93 / $0.93 / $1.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $54.95 / $85.11
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.93 / $0.93 / $0.93
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.93 / $0.93 / $0.93
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $0.89 / $1.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.93 / $0.93 / $1.29