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Vermont rates for HCPCS J0289

Amphotericin B Liposome Inj

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $21.48 / $38.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.32 / $24.32 / $24.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.27 / $26.39 / $43.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $21.48 / $21.48
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.27 / $26.39 / $43.98
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $21.48 / $21.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.41 / $21.48 / $33.04