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North Dakota 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 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,071.52 / $1,288.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,122.02 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,148.15 / $1,445.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $1,023.29 / $1,584.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,202.26 / $4,897.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,096.48 / $1,288.25