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Connecticut rates for HCPCS J0207

Injection, amifostine, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,092.83 / $1,531.40 / $3,592.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,028.55 / $1,092.83 / $1,105.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.41 / $1,577.77 / $3,128.73
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.41 / $1,092.83 / $1,092.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,092.83 / $1,092.83 / $1,092.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,092.83 / $1,092.83 / $1,092.83
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,092.83 / $1,178.55 / $1,357.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,017.84 / $1,071.41 / $1,178.55