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Montana rates for HCPCS C9254

Injection, lacosamide, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $64,565.42 / $95,499.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.20
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $79.43 / $85.11