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Utah rates for HCPCS J3250

Injection, trimethobenzamide HCl, up to 200 mg

Facilitymedian $138 · 10th–90th $66–$1450%20%10th90th$138Professionalmedian $58 · 10th–90th $58–$690%50%90th$58$2.0$5.0$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $138.04 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $72.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $75.86 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $57.54 / $74.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $83.18
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $58.88 / $58.88
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $57.54 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $57.54 / $57.54