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Missouri rates for HCPCS J3095

Telavancin Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.33 / $10.94 / $11.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.54 / $11.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.11 / $12.09 / $25.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.11 / $8.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.71 / $6.71 / $7.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.11 / $7.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.47 / $9.67 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.35 / $7.47 / $8.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.04 / $7.11 / $8.69