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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
$524.81 / $524.81 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $524.81 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $524.81 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $2,344.23 / $2,344.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $524.81 / $524.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $524.81 / $891.25