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Pennsylvania 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
$8.14 / $38.10 / $69.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.14 / $8.14 / $10.11
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.34 / $5.09 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.09 / $5.09 / $5.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.14 / $8.14 / $8.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.14 / $8.14 / $8.14
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.34 / $7.68 / $16.98
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.14 / $23.10 / $69.62
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.14 / $8.14 / $16.20
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.14 / $8.14 / $8.14
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.14 / $8.14 / $8.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.98 / $7.98 / $9.58