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Montana rates for HCPCS J0401

Injection, aripiprazole (Abilify Maintena), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.41 / $19.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $13.18 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.94 / $7.94 / $16.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.94
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.37 / $7.24 / $20.42
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.37 / $7.24 / $20.42
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.94 / $7.94 / $16.98
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $10.23 / $85.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24