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Indiana rates for HCPCS J9017

Injection, arsenic trioxide, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.92 / $17.28 / $40.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.09 / $8.15 / $8.97
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.15 / $16.30 / $19.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $8.15 / $11.24
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.86 / $8.15 / $12.23
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.74 / $8.15 / $10.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.15 / $8.15 / $8.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $8.15 / $40.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $8.73 / $16.30