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Alaska rates for HCPCS J3101

Injection, tenecteplase, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.94 / $1,119.30 / $18,420.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.66 / $320.33 / $400.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $172.22
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458.07 / $458.07 / $458.07
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $554.54
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.18 / $263.00 / $413.29
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$237.68 / $364.78 / $601.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $186.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $258.33 / $347.40