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Nebraska 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
$16.93 / $29.63 / $242.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.11 / $15.30 / $39.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.99 / $16.45 / $17.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.44 / $17.32 / $19.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.46 / $7.46 / $7.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $18.07 / $22.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.20 / $66.52 / $100.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $16.93 / $25.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.52 / $14.77 / $21.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $14.18 / $21.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.77 / $15.30 / $16.82