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Alaska rates for HCPCS J3095

Injection, telavancin, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.94 / $13.75 / $48.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.54 / $13.23 / $17.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.11 / $7.11
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.92 / $18.92 / $18.92
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.11 / $22.89
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.17 / $14.28 / $22.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.66 / $18.92 / $37.09
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.11 / $7.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $10.67 / $14.34