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Nebraska 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
$10.40 / $24.99 / $28.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.40 / $10.40 / $17.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.13 / $11.05 / $12.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.95 / $10.95 / $19.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $13.00 / $13.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.34 / $14.34 / $14.34
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.34 / $14.34 / $14.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.35 / $13.00 / $13.00