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Montana rates for HCPCS J0200

Injection, alatrofloxacin mesylate, 100 mg

Insurance Carrier
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $40.74 / $48.98
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $40.74 / $48.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95