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Pennsylvania rates for HCPCS J2765

Metoclopramide Hcl Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.09 / $4.19 / $14.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.12 / $2.50
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.08 / $1.27 / $251.84
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.18 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.02 / $1.09 / $1.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.09 / $1.09
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.25 / $6.43 / $10.80
Independence Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.08 / $1.23 / $241.80
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $4.59 / $37.86
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.01 / $1.19 / $3.04
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,316.98 / $2,831.42 / $4,445.76
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.02 / $1.09 / $1.09
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.09 / $1.09
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.10 / $1.10 / $1.28
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $1.10 / $1.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.15 / $1.88