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Montana rates for HCPCS J0456

Injection, azithromycin, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.73 / $36.90 / $507.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $3.16 / $10.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.30 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.54 / $2.54 / $10.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.54
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.54 / $2.54 / $10.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.21 / $2.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04