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Michigan rates for HCPCS J3101

Injection Tenecteplase 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.10 / $186.25 / $552.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $177.39 / $208.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.90 / $383.52 / $725.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.06 / $125.33 / $125.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.96 / $172.22 / $172.22
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$172.22 / $221.38 / $552.54
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $177.10 / $206.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$172.22 / $172.22 / $172.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $224.23