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South Carolina 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
$10.66 / $10.66 / $43.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.66 / $11.05 / $11.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.37 / $26.98 / $46.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.17 / $16.10 / $19.32
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.66 / $11.73 / $14.39
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $13.00 / $13.00