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Missouri rates for HCPCS J3415

Injection, pyridoxine HCl, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.16 / $26.08 / $31.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $7.07 / $26.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.11 / $6.59 / $15.92
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $7.56
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.05 / $23.01 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.88 / $12.80 / $14.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.14 / $6.05 / $7.40