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Michigan rates for HCPCS J3250

Injection, trimethobenzamide HCl, up to 200 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.58 / $90.80 / $148.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.00 / $57.51 / $63.26
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.80 / $125.42 / $238.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.66 / $60.93 / $79.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.06 / $57.51 / $64.77
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.40 / $97.13 / $153.04
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.00 / $57.51 / $69.01
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.04 / $57.54 / $86.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $57.51 / $61.98