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Nebraska rates for HCPCS J3095

Injection, telavancin, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.47 / $7.47 / $15.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.47 / $13.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.04 / $7.65 / $8.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.65 / $8.02 / $8.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.24 / $9.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.05 / $7.47 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.09 / $7.47 / $8.22
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.61 / $11.09 / $14.81
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.97 / $8.51 / $14.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.75 / $7.11 / $7.82