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Louisiana 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
$15.44 / $18.66 / $129.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.45 / $20.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.20 / $0.23 / $29.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.54 / $19.54 / $19.93
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.43 / $14.43 / $15.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.99 / $15.30 / $31.18