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Illinois rates for HCPCS J3415

Pyridoxine HCl IJ SOLN 100 MG/ML

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.33 / $12.80 / $70.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.29 / $15.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.86 / $47.19 / $120.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.05 / $6.05 / $6.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $6.05
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $12.83 / $81.81
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.87 / $7.87 / $7.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $10.89