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Massachusetts rates for HCPCS J1110

Injection, dihydroergotamine mesylate, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $83.40 / $817.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $62.40 / $116.48
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.75 / $161.55 / $198.78
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $85.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.38 / $76.56 / $163.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $60.00 / $60.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $60.00
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.20 / $94.80 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $127.20
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.33 / $68.52 / $622.25
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.68 / $153.68 / $367.35
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $90.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $90.00