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Nebraska rates for HCPCS J2995

Injection Streptokinase Per 250 000 Iu (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $180.20 / $207.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.00 / $75.00 / $125.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.50 / $90.00 / $90.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.50 / $89.09 / $90.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.50 / $82.50 / $103.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.75 / $142.50 / $389.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.69 / $90.69 / $99.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.39 / $91.58 / $184.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.39 / $125.14 / $200.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.16 / $90.69 / $90.69