go back

Hawaii rates for HCPCS J3095

Injection, telavancin, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.38 / $13.38 / $13.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.38 / $13.38 / $13.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.11 / $7.11
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.80 / $10.80 / $10.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.82 / $8.53 / $9.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $8.88 / $10.67
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.45 / $6.98 / $9.00