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Michigan rates for HCPCS J3415

Injection, pyridoxine HCl, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.23 / $24.69 / $64.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.23 / $6.72 / $15.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.07 / $19.94 / $37.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.66 / $8.66 / $9.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $11.78
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.05 / $25.60 / $61.95
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.23 / $13.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.95 / $14.45 / $14.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $6.42