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Vermont rates for HCPCS J0740

Injection Cidofovir 375 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $606.92 / $909.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$618.45 / $618.45 / $618.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$515.37 / $590.75 / $984.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $546.29
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$515.37 / $590.75 / $984.58
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $546.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.98 / $546.29 / $881.65