go back

Missouri rates for HCPCS J0207

Injection, amifostine, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,288.25 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,071.52 / $1,288.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,071.52 / $2,818.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,288.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $407.38 / $2,187.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,148.15 / $1,584.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,148.15 / $4,897.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,288.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,071.52 / $1,230.27