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Vermont rates for HCPCS J0720

Injection Chloramphenicol Sodium Succinate Up To 1 Gm (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.62 / $49.62 / $83.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.62 / $49.62 / $49.62
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.62 / $49.62 / $49.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.22 / $48.65 / $74.84