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Washington 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
$2.82 / $8.13 / $28.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.32 / $8.13 / $8.19
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.23 / $7.39 / $100.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.46 / $7.39 / $12.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.97 / $6.97 / $7.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $9.06
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.75 / $7.39 / $22.17
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.23 / $10.46 / $10.46
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.10 / $2.46 / $12.60
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.39 / $7.39 / $7.39
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $7.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $7.39