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Michigan rates for HCPCS J1110

Injection, dihydroergotamine mesylate, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.80 / $99.99 / $278.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $61.80 / $117.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.17 / $133.61 / $252.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.93 / $47.30 / $47.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.77 / $60.00 / $60.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $94.63 / $278.22
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $61.80 / $99.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.00 / $98.61 / $111.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $61.21