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Missouri rates for HCPCS J3101

Injection, tenecteplase, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.94 / $209.09 / $11,294.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $177.39 / $208.39
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$172.22 / $292.77 / $618.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $215.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.47 / $162.47 / $172.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $172.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.94 / $189.50 / $812.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.15 / $171.94 / $195.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$172.22 / $172.22 / $172.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.38 / $172.22 / $199.26