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Virginia rates for HCPCS J3250

Injection, trimethobenzamide HCl, up to 200 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.51 / $112.14 / $254.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $57.51 / $63.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $57.51 / $77.08
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.40 / $53.40 / $57.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.25 / $54.25 / $57.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $57.51 / $57.51
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.88 / $57.51 / $72.75
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.84 / $57.51 / $86.27
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.00 / $56.00 / $75.31
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.51 / $69.01 / $86.27
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $69.01 / $86.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $57.51 / $61.02