go back

North Dakota rates for HCPCS J1190

Injection, dexrazoxane HCl, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.76 / $63.06 / $63.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.83 / $63.06 / $70.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.41 / $68.75 / $69.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.15 / $68.65 / $69.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.46 / $82.46 / $103.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.09 / $113.90 / $287.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.09 / $36.58 / $92.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $70.20 / $76.23