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Indiana rates for HCPCS J2670

Injection, tolazoline HCl, up to 25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.31 / $3.31 / $14.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.02 / $3.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.47 / $4.57 / $4.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $3.47 / $5.75
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63,095.73 / $63,095.73 / $70,794.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.47 / $3.47 / $3.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $3.47 / $9.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $4.17 / $4.47