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Idaho 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
$16.93 / $20.07 / $118.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $16.93 / $20.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.43 / $15.30 / $15.30
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
$1.23 / $19.12 / $27.34
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $19.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.36 / $18.36 / $19.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30