go back

Utah rates for HCPCS J3095

Telavancin Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.25 / $8.25 / $8.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.25 / $8.25 / $8.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.66 / $10.11 / $11.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.11 / $7.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.34 / $14.26 / $20.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.11 / $7.11