go back

Indiana 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 / $47.57 / $194.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.45 / $16.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $30.60 / $45.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $15.30 / $21.72
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.30 / $15.30 / $22.95
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $19.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.67 / $15.30 / $34.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $26.01