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West 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
$30.72 / $40.64 / $127.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $17.10
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.30 / $22.95 / $22.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.43 / $15.30 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $27.36
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.22 / $36.54 / $43.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $36.68