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Indiana rates for HCPCS J0740

Injection, cidofovir, 375 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$534.66 / $1,267.20 / $5,463.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $551.76 / $551.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$546.29 / $1,092.58 / $1,447.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.34 / $546.29 / $775.73
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$546.29 / $546.29 / $819.44
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $682.86
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 / $1,452.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $928.69