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North Carolina rates for HCPCS J1190

Injection, dexrazoxane HCl, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.92 / $371.20 / $1,093.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.83 / $166.92 / $371.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.41 / $60.39 / $65.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.51 / $34.51 / $261.47
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 / $329.11
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.04 / $166.92 / $362.02
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.16 / $374.16 / $374.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $66.84 / $83.24
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.86 / $408.27 / $999.65