go back

Montana rates for HCPCS J1212

Injection, DMSO, dimethyl sulfoxide, 50%, 50 ml

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$714.72 / $756.33 / $1,665.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,171.24 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$815.87 / $815.87 / $1,870.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.84 / $748.84 / $815.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$815.87 / $815.87 / $1,870.42
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.84 / $812.43 / $1,059.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.85 / $748.85 / $748.85