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Alabama rates for HCPCS J1190

Injection Dexrazoxane Hydrochloride Per 250 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.09 / $63.06 / $85.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $70.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$934.22 / $1,133.72 / $1,525.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $243.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.06 / $63.06 / $63.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $344.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $66.84