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Connecticut rates for HCPCS J1050

Injection Medroxyprogesterone Acetate 1 Mg (Reinstated) Injection Medroxyprogesterone Acetate 100 Mg Special Coverage Instructions Apply. See Mcm: 2049) (Old Description - Deleted 06/30/2003)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.55 / $1.00 / $92.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $1.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.56 / $0.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.56
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.59 / $0.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.48 / $0.49