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Montana rates for HCPCS J0207

Injection, amifostine, 500 mg

Facilitymedian $759 · 10th–90th $380–$1,8200%20%10th90th$759Professionalmedian $1,072 · 10th–90th $1,023–$1,2880%50%10th90th$1,072$100.0$500.0$2.0K$10.0K$50.0K$200.0K$1.0M

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,071.52 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,096.48 / $1,096.48
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $741.31 / $776.25
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $741.31 / $776.25
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $1,047.13 / $1,862.09
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,096.48 / $1,348.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,174.90