go back

Iowa rates for HCPCS J1260

Injection Dolasetron Mesylate 10 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.63 / $13.53 / $20.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.63 / $5.63 / $5.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.38 / $6.38 / $7.97
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.28 / $14.86 / $17.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $6.00 / $12.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $12.20 / $14.52
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.26 / $5.01 / $7.67
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.26 / $6.26 / $9.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.20 / $12.44 / $14.52