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Michigan 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
$15.76 / $19.32 / $61.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.76 / $20.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.89 / $34.04 / $64.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.05 / $9.52 / $9.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.68 / $15.30 / $15.30
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.30 / $22.95 / $54.41
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.76 / $18.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.59 / $19.46 / $20.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.01 / $15.30 / $16.23