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Michigan 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
$6.70 / $17.18 / $93.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.66 / $7.66 / $8.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.59 / $10.08 / $19.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $1.85 / $1.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.07 / $8.14 / $8.14
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.66 / $14.94 / $89.03
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.66 / $8.46 / $10.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.98 / $7.98 / $7.98