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West Virginia rates for HCPCS J3250

Injection, trimethobenzamide HCl, up to 200 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.40 / $53.94 / $250.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $57.51 / $60.38
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.51 / $63.26 / $86.27
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $57.51 / $133.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.25 / $85.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $57.51 / $59.68
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.37 / $62.37 / $216.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.51 / $57.51 / $83.29