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Rhode Island 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
$49.73 / $49.73 / $51.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.93 / $16.93 / $31.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.43 / $15.30 / $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
$0.76 / $15.30 / $15.30