go back

Washington, DC 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
$546.29 / $1,492.85 / $2,011.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $546.29
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.37 / $847.94 / $1,433.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$515.37 / $515.37 / $546.29
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.35 / $464.35 / $546.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$497.12 / $546.29 / $885.42