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Hawaii 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
$22.68 / $22.68 / $22.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.67 / $22.67 / $22.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.97 / $17.97 / $17.97
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.82 / $18.36 / $21.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.77 / $15.30 / $22.95
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.49 / $10.68 / $16.93