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North Carolina rates for HCPCS J1110

Injection, dihydroergotamine mesylate, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.09 / $91.52 / $359.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.80 / $57.80 / $117.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.47 / $103.77 / $139.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.35 / $83.35 / $97.07
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 / $109.80
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.80 / $71.40 / $111.16
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.46 / $22.46 / $22.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $79.20
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.68 / $153.68 / $367.35