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Nebraska rates for HCPCS J3250

Injection, trimethobenzamide HCl, up to 200 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.40 / $57.51 / $127.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $57.51 / $89.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.33 / $65.09 / $65.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.43 / $61.84 / $65.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.00 / $58.08 / $77.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.26 / $77.43 / $104.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.04 / $53.40 / $202.92
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.63 / $60.05 / $76.43
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.42 / $60.05 / $77.06
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.90 / $67.39 / $117.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.63 / $57.51 / $72.75