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Montana rates for HCPCS J1240

Injection, dimenhydrinate, up to 50 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.69 / $7.82 / $17.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.86 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.52 / $9.52 / $20.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $6.14 / $9.52
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.52 / $9.52 / $20.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $6.66 / $9.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $6.14 / $6.14