go back

Nebraska 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
$529.38 / $546.29 / $1,207.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.38 / $546.29 / $1,745.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.85 / $618.46 / $618.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$569.34 / $599.29 / $618.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$755.00 / $755.00 / $755.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.67 / $546.29 / $664.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.96 / $529.37 / $3,331.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.83 / $529.38 / $794.07
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.65 / $695.89 / $1,080.67
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.43 / $695.89 / $1,540.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.98 / $546.29 / $600.91