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Idaho rates for HCPCS J3400

Injection Triflupromazine Hcl Up To 20 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.00 / $13.00 / $13.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.40 / $11.05 / $13.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.05 / $11.05 / $11.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.05 / $11.05 / $11.05
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.05 / $11.85 / $15.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.00 / $78.00 / $78.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $13.00 / $13.00