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Wyoming rates for HCPCS J0850

Injection Cytomegalovirus Immune Globulin Intravenous (Human) Per Vial (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,809.44 / $1,809.44 / $1,809.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,808.65 / $1,808.65 / $1,809.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,791.99 / $2,108.21 / $2,108.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,706.27 / $1,706.27 / $1,706.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,808.65 / $1,808.65 / $2,559.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,808.65 / $1,808.65 / $2,025.69