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Utah rates for HCPCS J3360

Injection, diazepam, up to 5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $87.10 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.03 / $7.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $10.00 / $12.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $8.91 / $13.80
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.61 / $7.41 / $7.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76