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Mississippi 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
$38.50 / $38.50 / $75.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $66.20 / $75.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.18 / $117.18 / $117.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.06 / $63.06 / $97.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $63.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $64.31 / $87.38