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North Dakota 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
$15.30 / $15.30 / $30.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $20.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $16.68 / $16.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.11 / $16.66 / $16.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.07 / $18.07 / $22.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.15 / $16.93 / $30.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.93 / $16.93 / $18.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.01 / $15.30 / $16.62