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Louisiana rates for HCPCS J3410

Injection, hydroxyzine HCl, up to 25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $25.70 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $12.88 / $14.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $16.22 / $16.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $16.22 / $16.60
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.30 / $12.30 / $12.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $12.88 / $12.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.79 / $18.62 / $21.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $12.88 / $19.50