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Ohio rates for HCPCS J1110

Injection, dihydroergotamine mesylate, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.17 / $151.80 / $563.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $68.89 / $151.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $140.40 / $390.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $101.16
Aultcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.40 / $80.40 / $80.40
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $60.00 / $102.00
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $81.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.61 / $56.61 / $60.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $135.13
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.90 / $190.86 / $391.40
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $135.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.00 / $106.77 / $135.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $78.12