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Iowa 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
$799.05 / $1,037.23 / $1,207.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $782.34 / $1,037.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.67 / $626.19 / $664.59
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $988.78 / $1,427.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$391.43 / $626.19 / $1,037.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$451.65 / $529.38 / $1,002.84
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$391.43 / $635.25 / $1,080.67
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.66 / $695.89 / $1,066.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $562.67
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$529.38 / $529.38 / $529.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.38 / $529.38 / $529.38