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Kansas rates for HCPCS J2560

Injection Phenobarbital Sodium Up To 120 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $137.66 / $1,037.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.17 / $32.58 / $48.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.09 / $42.20 / $83.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.61 / $32.61 / $32.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.46 / $28.46 / $30.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.17 / $30.17 / $30.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.91 / $41.64 / $48.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.36 / $27.36 / $43.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.17 / $30.17 / $48.27