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Texas 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
$3.29 / $12.53 / $84.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.44 / $7.39 / $7.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.76 / $6.99 / $13.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.19 / $8.19 / $8.19
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.33 / $7.39 / $120.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.97 / $7.39 / $7.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $7.39
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.67 / $10.67 / $51.80
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.06 / $7.03 / $13.48
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.11 / $7.39 / $10.67
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.87 / $7.39 / $8.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $7.39
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $2.14 / $9.98