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Nebraska rates for HCPCS J2997

Injection, alteplase recombinant, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $218.78 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $281.84 / $323.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $107.15 / $107.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $102.33 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.15 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $95.50 / $120.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $199.53 / $478.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $93.33 / $104.71
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $141.25 / $141.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $93.33 / $181.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $93.33 / $112.20