go back

Nebraska rates for HCPCS J0207

Injection, amifostine, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,028.55 / $2,189.89 / $2,841.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,028.55 / $1,041.41 / $1,726.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,092.85 / $1,285.72 / $1,285.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,221.43 / $1,285.72 / $1,285.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.42 / $1,092.83 / $1,545.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$523.83 / $1,316.54 / $1,954.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,007.74 / $1,071.41 / $4,885.62
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$508.87 / $531.42 / $1,584.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.11 / $1,007.74 / $1,591.88
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$596.40 / $596.40 / $764.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.41 / $1,071.41 / $1,274.98