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Utah rates for HCPCS J3415

Pyridoxine HCl IJ SOLN 100 MG/ML

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.01 / $7.01 / $14.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.01 / $7.01 / $7.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.94 / $20.85 / $23.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.05 / $6.05 / $6.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $6.05 / $6.05