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Washington rates for HCPCS J2560

Injection, phenobarbital sodium, up to 120 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.18 / $118.90 / $1,238.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.17 / $33.18 / $55.94
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.17 / $49.23 / $181.25
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.17 / $33.36 / $48.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.46 / $28.46 / $58.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.17 / $30.17 / $37.00
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.36 / $34.20 / $90.51
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.27 / $39.95 / $39.95
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.18 / $35.40 / $48.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.17 / $39.38 / $51.19
Regence BlueShield
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 / $30.17