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Louisiana rates for HCPCS J0791

Injection Crizanlizumab-Tmca 5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$129.58 / $136.06 / $386.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $130.77 / $156.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.01 / $118.52 / $142.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.44 / $142.44 / $145.30
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,922.18 / $14,922.18 / $14,922.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.15 / $122.15 / $129.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $129.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.89 / $129.47 / $161.85