go back

Nebraska rates for HCPCS J3415

Injection, pyridoxine HCl, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.63 / $12.80 / $27.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $12.80 / $21.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.14 / $6.85 / $6.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.50 / $6.84 / $14.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $12.83 / $16.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.01 / $33.22 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.52 / $12.80 / $14.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.58 / $15.08 / $18.93
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.65 / $15.08 / $23.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $6.05 / $9.08