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Montana rates for HCPCS J0692

Cefepime Hcl For Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.10 / $36.00 / $89.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.35 / $4.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.86 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.37 / $5.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.22 / $1.37
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.37 / $5.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.32 / $1.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.22 / $1.22