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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
$1,028.55 / $1,028.55 / $1,967.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,028.55 / $1,067.11 / $1,285.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$959.58 / $1,130.59 / $1,145.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,092.83 / $1,157.25 / $1,446.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$540.94 / $1,003.59 / $1,285.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.41 / $1,192.70 / $4,885.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.41 / $1,192.70 / $1,285.69