go back

Utah rates for HCPCS J3260

Injection, tobramycin sulfate, up to 80 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $158.49 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.86 / $2.57 / $3.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.09 / $4.57
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $2.34 / $2.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04