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Connecticut rates for HCPCS J0740

Injection Cidofovir 375 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$568.15 / $826.87 / $1,526.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.15 / $568.15 / $568.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.51 / $830.47 / $1,808.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $546.29
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
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$566.91 / $592.67 / $683.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.66 / $546.29 / $954.25