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Utah rates for HCPCS J2730

Injection, pralidoxime chloride, up to 1 g

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $85.11 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $89.13 / $89.13
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $93.33 / $112.20
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $38.02 / $43.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10