go back

Vermont 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
Professional
Modifier
Low / Median / High Price
$0.55 / $0.59 / $0.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.78 / $0.90 / $2.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.56
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.48 / $0.74