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Indiana rates for HCPCS J1110

Injection, dihydroergotamine mesylate, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.07 / $265.00 / $958.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.60 / $97.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.00 / $120.00 / $180.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.00 / $60.00 / $85.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $60.00 / $90.00
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $87.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $60.00 / $60.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.31 / $60.00 / $132.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $80.66