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Utah rates for HCPCS J3280

Injection Thiethylperazine Maleate Up To 10 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.16 / $6.16 / $6.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.16 / $6.16 / $6.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.76 / $4.76 / $4.76
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.01 / $6.66 / $8.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.76 / $4.76 / $4.76