go back

Delaware 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
$217.21 / $217.21 / $242.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $39.47 / $39.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.00 / $121.00 / $121.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $22.95 / $35.95