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Illinois 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
$15.30 / $26.78 / $113.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.76 / $20.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.81 / $56.54 / $254.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.21 / $18.36 / $31.71
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.89 / $19.89 / $19.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $20.46