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Alaska rates for HCPCS J3415

Injection, pyridoxine HCl, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.46 / $60.81 / $89.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.72 / $11.25 / $29.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $6.05
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.09 / $16.09 / $16.09
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $19.48
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.82 / $36.51 / $57.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.23 / $36.51 / $86.06
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $6.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $9.08 / $12.20