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Missouri rates for HCPCS J0740

Injection, cidofovir, 375 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$529.38 / $1,037.23 / $1,089.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $562.67 / $1,037.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$546.29 / $595.46 / $1,962.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $682.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$515.37 / $515.37 / $546.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $546.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$529.37 / $1,025.79 / $3,331.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$449.97 / $529.38 / $612.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.35 / $546.29 / $668.11