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Minnesota rates for HCPCS J0207

Injection, amifostine, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $1,288.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,071.52 / $1,288.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,621.81 / $1,737.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,096.48 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $3,890.45 / $4,677.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,230.27 / $1,479.11
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $3,715.35 / $4,365.16
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,148.15 / $1,318.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $1,148.15 / $1,202.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,148.15 / $4,897.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,096.48 / $1,659.59