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Wyoming rates for HCPCS J1190

Injection, dexrazoxane HCl, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.09 / $32.09 / $32.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.09 / $32.09 / $63.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.74 / $329.11 / $329.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.49 / $59.49 / $59.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $89.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $70.20