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Alaska rates for HCPCS J7121

5% Dextrose In Lactated Ringers Infusion, Up To 1000 Cc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $67.61 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.94 / $12.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $8.13 / $8.13
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $64.57 / $537.03
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $8.13 / $60.26
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.49 / $13.49 / $20.89
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $9.12 / $9.12
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $12.88 / $18.62
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $8.13 / $60.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $12.02 / $23.99