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Indiana rates for HCPCS J3105

Injection Terbutaline Sulfate Up To 1 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.96 / $12.47 / $144.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.48 / $7.39 / $7.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.76 / $14.78 / $22.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.28 / $7.39 / $10.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.39 / $7.39 / $9.98
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $9.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.39 / $7.39 / $7.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $7.39 / $7.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $12.56