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Montana rates for HCPCS J0289

Injection, amphotericin B liposome, 10 mg

Facilitymedian $30 · 10th–90th $17–$810%20%10th90th$30Professionalmedian $22 · 10th–90th $20–$740%50%10th90th$22$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $20.89 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $26.92
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $29.51 / $81.28
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $29.51 / $81.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $77.62
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $32.36 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $20.89 / $20.89