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Arizona rates for HCPCS J3250

Injection, trimethobenzamide HCl, up to 200 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.54 / $115.02 / $172.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $58.08 / $70.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.60 / $165.68 / $286.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.69 / $55.21 / $60.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.25 / $57.51 / $57.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $57.51 / $57.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.84 / $58.74 / $98.34
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.40 / $53.40 / $309.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $57.51 / $57.51