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Vermont rates for HCPCS J3410

Injection Hydroxyzine Hcl Up To 25 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $29.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.32 / $17.32 / $17.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.43 / $20.11 / $29.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.43 / $20.11 / $29.59
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.54 / $15.30 / $31.18