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Florida 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
$36.90 / $110.99 / $3,583.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $69.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.49 / $63.06 / $84.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $63.06
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.06 / $63.06 / $188.58
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $66.63 / $66.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $66.84 / $113.22
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.09 / $32.09 / $63.06