go back

Louisiana rates for HCPCS J3415

Injection, pyridoxine HCl, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.11 / $13.44 / $38.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.23 / $15.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.83 / $13.83 / $20.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.83 / $13.83 / $14.11
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.70 / $5.70 / $6.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $6.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $12.64