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Oregon 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 / $26.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.79 / $10.79 / $13.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.10 / $22.10 / $22.10
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
$10.79 / $15.43 / $23.20
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,910.16 / $17,150.38 / $18,772.80
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79,999.20 / $79,999.20 / $79,999.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.79 / $15.43 / $2,400,000.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.05 / $11.05 / $11.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $13.00 / $13.00