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Montana rates for HCPCS C9254

Injection, lacosamide, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.40 / $86.40 / $86.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
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 / $0.20 / $0.24