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South Carolina 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
$10.60 / $17.50 / $494.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.11 / $16.05 / $20.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $6.54 / $47.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.26 / $14.63 / $19.12
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.47 / $16.05 / $35.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30