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Virginia 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
$16.05 / $35.54 / $127.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $16.05 / $16.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $22.57 / $34.06
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.01 / $18.36 / $36.68
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $15.30 / $32.10
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.54 / $18.51 / $33.35
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.54 / $18.51 / $33.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.84 / $15.30 / $19.20