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West Virginia rates for HCPCS J0841

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,044.14 / $1,044.14 / $1,055.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,045.15 / $1,045.15 / $1,055.59
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,045.15 / $1,567.73 / $1,567.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$985.99 / $1,045.15 / $1,346.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,045.15 / $1,045.15 / $1,993.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,013.80 / $1,045.15 / $1,584.00