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West Virginia rates for HCPCS J1110

Injection, dihydroergotamine mesylate, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.60 / $197.65 / $197.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $98.04
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $90.00 / $90.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.61 / $60.00 / $85.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $114.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $100.83