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Minnesota rates for HCPCS 80376

Drug/Substance Definitive Qual/Quant Nos 4-6

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.00 / $184.00 / $184.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.30 / $82.35 / $186.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.44 / $24.30 / $24.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.57 / $112.04 / $112.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.28 / $15.63 / $51.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.16 / $14.68 / $51.50