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Rhode Island rates for HCPCS J1110

Injection, dihydroergotamine mesylate, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.00 / $195.00 / $195.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $62.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $97.07 / $102.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $60.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.61 / $60.00 / $60.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $60.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.94 / $60.00 / $60.00