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Utah rates for HCPCS J1245

Injection, dipyridamole, per 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $8.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.47 / $5.50 / $5.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $8.32 / $8.32
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $8.71 / $8.71
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $8.32 / $10.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $8.32 / $8.32