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Tennessee rates for HCPCS J1110

Injection, dihydroergotamine mesylate, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $162.11 / $355.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $117.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.05 / $101.05 / $101.05
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 / $60.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.68 / $367.35 / $367.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $85.71