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Indiana rates for HCPCS J0741

Injection, cabotegravir and rilpivirine, 2 mg/3 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.87 / $66.40 / $23,597.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.65 / $23.89 / $23.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.65 / $47.30 / $62.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.10 / $23.65 / $33.58
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.65 / $23.65 / $32.08
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.65 / $23.65 / $27.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.65 / $23.65 / $23.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.56 / $23.65 / $62.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.65 / $23.65 / $29.33