go back

Wyoming 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 / $1,044.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,044.14 / $1,044.14 / $1,045.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,346.40 / $1,584.00 / $1,584.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$985.99 / $985.99 / $985.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,045.15 / $1,045.15 / $1,478.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,087.10 / $2,087.10 / $2,295.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,045.15 / $1,045.15 / $1,045.15