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West Virginia rates for HCPCS J0740

Injection, cidofovir, 375 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$529.38 / $529.38 / $551.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $551.75 / $606.92
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$546.29 / $819.44 / $819.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$515.37 / $546.29 / $881.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $1,027.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.29 / $546.29 / $1,037.23