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Alaska rates for HCPCS J0740

Injection, cidofovir, 375 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$610.91 / $974.79 / $3,446.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.66 / $1,016.11 / $1,745.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $546.29
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,453.04 / $1,453.04 / $1,453.04
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $1,759.05
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$454.50 / $1,452.12 / $2,281.91
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$822.24 / $1,453.04 / $3,422.86
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $592.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $819.44 / $1,101.98