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Washington rates for HCPCS J3101

Injection Tenecteplase 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.07 / $211.83 / $22,188.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $189.44 / $208.39
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.91 / $236.21 / $456.66
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $199.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.47 / $162.47 / $393.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $211.21
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.47 / $172.22 / $356.85
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.27 / $244.98 / $428.72
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.37 / $176.23 / $187.86
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.69 / $188.96 / $350.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $172.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.46 / $162.46 / $162.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $172.22