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Idaho rates for HCPCS J0470

Injection, dimercaprol, per 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.55 / $54.55 / $54.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.34 / $54.55 / $55.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.55 / $54.55 / $54.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.55 / $54.55 / $54.55
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $55.19 / $78.92
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.46 / $30.46 / $30.46
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.00 / $78.00 / $78.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.79 / $89.72 / $152.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.42 / $56.42 / $56.42