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Tennessee 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 / $34.72 / $81.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $20.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.60 / $33.60 / $33.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $31.18