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Michigan rates for HCPCS J0740

Injection, cidofovir, 375 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$545.26 / $562.67 / $1,701.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$545.26 / $562.67 / $640.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$675.32 / $1,216.56 / $2,301.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.69 / $476.52 / $476.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $939.14
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$546.29 / $954.21 / $1,517.19
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$545.26 / $546.29 / $655.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$600.10 / $608.78 / $628.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $579.55