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Utah rates for HCPCS J0841

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,211.20 / $1,212.36 / $1,212.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,212.36 / $1,212.36 / $1,212.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,201.59 / $1,356.64 / $1,560.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,045.15 / $1,045.15 / $1,045.15
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,711.35 / $2,193.73 / $3,063.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,045.15 / $1,045.15 / $1,045.15