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Montana rates for HCPCS J0221

Injection, alglucosidase alfa, (Lumizyme), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.18 / $250.01 / $457.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.09 / $230.09 / $513.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.59 / $206.59 / $230.09
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.09 / $230.09 / $513.77
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.59 / $224.14 / $292.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.59 / $206.59 / $206.59