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Pennsylvania rates for HCPCS J3486

Injection, ziprasidone mesylate, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.25 / $14.70 / $45.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $6.83 / $62.54
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.30 / $7.41 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $7.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.44 / $6.83 / $6.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.83 / $6.83 / $6.83
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.01 / $43.60 / $67.20
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.23 / $9.55 / $57.45
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.17 / $6.83 / $9.55
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.44 / $6.83 / $6.83
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.83 / $6.83 / $6.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.16 / $10.16 / $11.78
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.16 / $10.16 / $11.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.83 / $6.83 / $12.50