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Montana rates for HCPCS J0740

Injection, cidofovir, 375 mg

Facilitymedian $741 · 10th–90th $589–$3,3880%20%10th90th$741Professionalmedian $575 · 10th–90th $525–$1,4450%50%10th90th$575$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $1,445.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $46,773.51 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $588.84
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $691.83 / $1,698.24
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $691.83 / $1,698.24
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $1,737.80
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $562.34 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81