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Washington 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
$15.49 / $21.03 / $148.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $16.82 / $20.51
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.30 / $18.57 / $100.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.16 / $15.30 / $33.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.43 / $14.43 / $19.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $18.76
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.30 / $19.13 / $45.90
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.57 / $27.89 / $27.89
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.07 / $14.16 / $33.60
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30