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Ohio rates for HCPCS J2504

Injection, pegademase bovine, 25 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.25 / $770.64 / $1,053.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.25 / $333.25 / $926.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $551.94 / $919.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.96 / $367.96 / $588.73
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.86 / $140.86 / $193.43
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.86 / $140.86 / $140.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.96 / $367.96 / $367.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.96 / $367.96 / $557.10
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.96 / $367.96 / $367.96
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.96 / $367.96 / $557.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$404.75 / $459.95 / $533.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.54 / $357.54 / $497.37