go back

Montana rates for HCPCS J0717

Injection, certolizumab pegol, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.95 / $4.34 / $8,160.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.98 / $68,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.55 / $4.55 / $24.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $3.91 / $4.55
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.55 / $4.55 / $24.46
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $4.24 / $5.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $3.91 / $3.91