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Oklahoma rates for HCPCS J1110

Injection, dihydroergotamine mesylate, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.80 / $104.84 / $939.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.80 / $64.80 / $64.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.62 / $193.56 / $304.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.61 / $56.61 / $60.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.53 / $60.00 / $60.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.66 / $104.84 / $153.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.51 / $97.07 / $97.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $64.30