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Idaho rates for HCPCS J3415

Injection, pyridoxine HCl, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.51 / $12.80 / $16.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $7.56 / $15.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.70 / $6.05 / $6.05
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
$0.41 / $7.56 / $10.81
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $7.56
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.26 / $7.26 / $7.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $9.68