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Alaska rates for HCPCS J3410

Injection Hydroxyzine Hcl Up To 25 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.60 / $93.02 / $237.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.10 / $28.45 / $39.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.68 / $40.68 / $40.68
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $49.27
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.57 / $47.04 / $73.92
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.89 / $45.01 / $106.09
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $16.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $22.95 / $30.86