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Hawaii rates for HCPCS J0841

Injection, crotalidae immune F(ab')2 (equine), 120 mg

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,045.15 / $1,045.15 / $1,045.15
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,499.67 / $1,499.67 / $1,769.61
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,149.67 / $1,254.18 / $1,463.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,045.15 / $1,232.59 / $1,567.73
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$987.00 / $1,242.88 / $1,513.15