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Massachusetts rates for HCPCS J3415

Injection, pyridoxine HCl, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.05 / $8.41 / $27.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.29 / $12.93
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.19 / $16.21 / $100.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $22.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.49 / $7.72 / $16.46
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.20 / $53.00 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $12.83
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $22.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $22.17