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Missouri 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
$16.04 / $30.72 / $72.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $17.10 / $35.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.68 / $26.01 / $40.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $19.13
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.40 / $26.78 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.39 / $16.93 / $19.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.01 / $15.30 / $19.07