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Iowa rates for HCPCS J3415

Injection, pyridoxine HCl, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.32 / $22.82 / $28.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $8.68 / $22.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.83 / $13.43 / $16.03
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.36 / $6.05 / $28.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.00 / $15.26 / $22.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.68 / $12.80 / $21.67
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.00 / $15.26 / $20.51
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.02 / $15.08 / $21.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $6.23
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.80 / $12.80 / $12.80
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.80 / $12.80 / $12.80