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Utah rates for HCPCS J0470

Injection, dimercaprol, per 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $52.48 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $52.48 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $54.95
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $223.87
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $69.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $56.23 / $56.23