go back

Louisiana 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
$27.64 / $30.47 / $81.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.36 / $30.47 / $33.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.49 / $3.93 / $48.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.38 / $32.38 / $33.03
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.17 / $30.17 / $46.88