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Vermont rates for HCPCS J0288

Ampho B Cholesteryl Sulfate

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.60 / $13.60 / $22.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.00 / $14.00 / $14.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.00 / $14.00 / $14.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.60 / $16.00 / $24.61