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Hawaii rates for HCPCS J3415

Injection, pyridoxine HCl, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.32 / $19.32 / $19.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $8.30 / $19.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.32 / $19.32 / $19.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $6.05
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.04 / $23.04 / $23.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.65 / $7.26 / $8.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $18.93
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.92 / $12.70 / $19.09