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Washington rates for HCPCS J1110

Injection, dihydroergotamine mesylate, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.50 / $184.81 / $261.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $66.00 / $146.63
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $61.94 / $367.35
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.23 / $60.00 / $101.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.61 / $56.61 / $171.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $73.59
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $91.58 / $180.00
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.94 / $83.87 / $83.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.26 / $47.23 / $101.05
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $60.00 / $229.55
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $60.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $60.00