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Arizona rates for HCPCS J0740

Injection, cidofovir, 375 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$584.53 / $1,065.63 / $1,638.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$551.75 / $640.54 / $1,745.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$454.62 / $1,830.07 / $2,974.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$352.30 / $512.44 / $3,475.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$546.29 / $546.29 / $546.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $546.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$529.38 / $832.70 / $1,165.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.38 / $529.38 / $529.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $546.29